Functional and radiological outcome of surgical treatment of distal tibial fracture by minimally invasive percutaneous plate osteosynthesis technique
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20200736Keywords:
Distal tibia fracture, Locking compression plate, Percutaneous plating, Distal tibia fracturesAbstract
Background: Minimally invasive percutaneous plate osteosynthesis (MIPPO) is an established technique for fixation of fractures of the distal third tibia. Aim of our study was to manage extraarticular fractures of the distal third tibia by the minimally invasive plate osteosynthesis technique and follow them prospectively. Clinical and radiological outcomes were studied and clinical indications & efficacy of the procedure reviewed.
Methods: From June 2018 to June 2019,25 patients of closed distal tibial fractures were operated by MIPPO technique with a distal tibial anatomical locking plate having 4.5 out of 5 proximal and 3.5 out of 4 distal screw holes. The follow up duration was for 1 year.
Results: The mean fracture healing time was 17 weeks (range 16 to 32 weeks) and average The American orthopedic foot and ankle score was 88.2 out of a total possible 100 points. At last follow up, superficial infection occurred in 3 patients, deep infection in 1 patient, ankle stiffness in 1 patient, limb length discrepancy <1 cm in 1 patient and malunion in 2 patients.
Conclusions: MIPPO technique provides good bone healing and decreases incidence of non-union and need for bone grafting. This technique should be used in distal tibia fractures where locked nailing cannot be done like fractures with small distal metaphyseal fragments, vertical splits, markedly comminute fractures.
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References
Michael Sirkin, Roy Sanders. The treatment of pilon fractures. Clinic Orto. 2001;32(1):91-102.
Russell TA. Fractures of the tibia and fibula. In: Rockwood CA, Green DP, Buckolz RW, Heckman JD, editors. Fractures in adults. 4th ed. Philadelphia: Lippincott; 1996: 2139-2157.
Bedi A, Le TT, Karunakar MA. Surgical Treatment of Nonarticular Distal Tibia Fractures. J Am Acad Orthop Surg. 2006;14(7):406-16.
Shrestha D, Acharya BM, Shrestha PM. Minimal invasive plate osteosynthesis with locking compression plate for distal diametaphyseal tibia fracture. Kathmandu Univ Med J. 2011;34(2):62-8.
Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18:488-93.
Kaab MJ, Frenk A, Schmeling A, Schaser K, Schutz M, Haas NP. Locked internal fixator: sensitivity of screw/plate stability to the correct Insertion angle of the screw. J Orthop Trauma. 2004;18:483-7.
Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P, Tscherne H. Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaveric injection study. Injury. 1999;30:591-8.
Borelli J, Prickett W, Song E, Becker D, Ricci W. Extra osseous blood supply of the tibia and the effects of different plating techniques: human cadaveric study. J Orthop Trauma. 2002;16:691-5.
Im GI, Tae SK. Distal metaphyseal fractures of tibia a prospective Randomized trial of closed reduction and intramedullary nail versus open Reduction and plate and screws fixation. J Trauma. 2005;59(5):1219-23.
Paluvadi SV, Lal H, Mittal D. Management of fractures of the distal third tibia by minimally invasive plate osteosynthesis - a prospective series of 50 patients. J Clin Orthop Trauma. 2014;5(3):129-36.
Cheng W, Li Y, Manyi W. Comparison study of two surgical options for distal tibia fracture-minimally invasive plate osteosynthesis vs. open reduction and internal fixation. Int Orthop (SICOT). 2011;35:737–42.
Kao FC, Tu YK, Hsu KY, Wu CH, Yen Cy, Chou MC. Treatment of distal tibial fractures by minimally invasive percutaneous plate osteosynthesis of three different plates: Results and cost-effectiveness analysis. Formosan J Musculoskeletal Dis. 2010;1:35-40.
Borg T, Larsson S, Lindsjo U. Percutaneous plating of distal tibial fractures. Preliminary results in 21 patients. Injury. 2004;35:608-14.
Maffulli N, Toms AD, McMurtie A, Oliva F. Percutaneous plating of distal tibial fractures. Int Orthop. 2004;28:159-62.
Guo JJ, Tang N, Yang HL, Tang TS. A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia. J Bone Joint Surg Br. 2010;92:984-8.
Cory Collinge MD, Mark Kuper DO, Kirk Larson, RNFA, and Robert Protzman MD. Minimally Invasive Plating of High-Energy Metaphyseal Distal Tibial Fractures. J Orthop Trauma. 2007;21:355-61.
Mustaq A, Shahid R, Asif M, Maqsood M. Distal Tibial fracture fixation with locking compression plate (LCP) using minimally invasive percutaneous osteosynthesis (MIPO) technique. Eur J Trauma Emerg Surg. 2008;35(2):159-64.
Ali SKI, Ravikumar K, Sheth S, Sinha AK, Karale A, Swamy MKS. Evaluation of the functional outcome in distal tibia fractures managed by MIPPO technique using distal tibia locking plate. Int J Orthop Sci. 2017;3(2):441-4.
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