A prospective study of surgical management of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis using locking compression plate

Raghu Kumar J., Manjappa D. H.


Background: Distal tibial fractures are unique and represent a significant challenge in their management. Factors affecting the outcome include location of fractures, proximity to ankle joint, less soft tissue coverage, comminution, unstable and compound fractures, method of treatment and quality of reduction. Distal tibial fractures traditionally were treated with different modalities, LCP with MIPPO (minimally invasive percutaneous plate osteosynthesis) being one of the recent advances.

Methods: Clinical, prospective observational study was conducted at J.J.M. Medical College, Davangere between October 2014 to September 2016. 21 patients with distal 1/3rd tibial fractures with or without intra-articular extensions were included in this study.  All 21 patients treated with LCP by MIPPO were followed for 6 months with clinical and radiological assessment, including ankle scoring system (Olerud and Mollander).

Results: 21 patients with age between 23-65 years (mean 41.6 years) were treated with LCP by MIPPO during the study period. All the patients were followed up at 6 weeks, 12 weeks, 6 months and at 1 year with x-ray and ankle scoring system. All the patients had complete union between 14 weeks to 24 weeks with ankle score between excellent and good in majority of the patients.  There were 2 cases of delayed union, 3 superficial skin infections and 3 cases of ankle stiffness.

Conclusions: Study concludes LCP with MIPPO is a safe, reliable technique to achieve complete union of difficult fractures.



Distal tibial fracture, Locking compression plate, MIPPO

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