Minimally Invasive Plate Osteosynthesis in Management of Distal Tibia Fractures

Abstract

Introduction: Unstable fractures of distal tibia with or without intra-articular extension can present a clinical dilemma. Historically, there have been a variety of methods of management described but with high rates of associated complications. Minimally Invasive Plate Osteosynthesis (MIPO), has now become more popular with the development of the Locking Compression Plates. MIPO offers many biological advantages including minimal soft tissue dissection with preservation of vascular integrity of the fracture as well as preserving osteogenic fracture haematoma. Materials & Methods: A total of 30 patients with distal tibia fractures (open/closed) were included in the study after informed consent. Patients were treated by MIPO with LCP and were prospectively followed up. Duration of follow-up ranged from 12–36 weeks. Demographic variables, mode of injury, time required for union, complications and clinical improvement were recorded and analysed. Results: Most of the fractures were united by 20 th week (80%) with mean union time of 17.9 ± 3.2 weeks. Excellent clinical results with MIPO were observed in 46.7% cases while poor results were obtained in 10% cases. Complications were seen in 13 subjects (43.3%), of which most common was wound infection, seen in 13.3% of the cases. Delayed union was noted in 1 case while no case of non union was observed. Conclusion: MIPO is an effective technique for the management of distal tibial fractures. It is minimally invasive, though technically demanding, but preserves the biological environment by preserving the soft tissue with better outcome in terms of radiological union and clinical improvement.

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