Clinical and radiological outcome of minimally invasive plate osteosynthesis in distal tibial fractures: a retrospective analysis

Authors

  • Mahantesh Magadum Department of Orthopedics Surgery, Trichy SRM Medical College and Hospital Trichy, Tamil Nadu, India
  • Deeppak D. Chitragar Department of Orthopedics Surgery, Trichy SRM Medical College and Hospital Trichy, Tamil Nadu, India
  • Shreyas Zalariya HCG Hospital, Rajkot/Kushi, Gujarat, India
  • Manjunath K. L. Fortis Hospital, Nagarabhaavi, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251133

Keywords:

Distal tibial fractures, MIPO, Fracture healing, AOFAS score, Visual analog scale, Complications

Abstract

Background: Distal tibial fractures are a common injury that poses challenges in terms of treatment and outcomes. Minimally invasive plate osteosynthesis (MIPO) has emerged as a promising technique, reducing the need for large incisions while promoting faster recovery and fewer complications compared to traditional open reduction and internal fixation (ORIF). This study evaluates the clinical and radiological outcomes of MIPO in patients with distal tibial fractures.

Methods: A retrospective analysis of 40 patients who underwent MIPO for distal tibial fractures between November 2022 and November 2024 at a Tertiary healthcare center, was conducted. Fractures were classified according to the AO/OTA system. Outcomes such as fracture healing, functional recovery (measured using the AOFAS score), pain relief (assessed via the VAS), and complication rates were evaluated. Statistical analysis was performed using SPSS version 25, with p<0.05 considered significant.

Results: The mean age of the patients was 42.5±12.3 years. The majority of fractures were classified as type 43-A (70%). Fracture healing was achieved in 95% of cases by 24 weeks, with a mean time to union of 14.3±3.2 weeks. The AOFAS scores improved significantly from 72.5±13.1 at 6 weeks to 85.2±10.3 at 12 weeks (p<0.05). Pain reduction was also significant, with VAS scores decreasing from 6.25±2.14 at 6 weeks to 1.56±1.26 at 24 weeks (p<0.05). Complications were noted in 10% of cases, including superficial infection and delayed union.

Conclusions: MIPO offers favourable outcomes in the treatment of distal tibial fractures, with significant improvements in fracture healing, functional recovery, and pain reduction. The technique is associated with a low complication rate, making it a viable option for managing these fractures.

Metrics

Metrics Loading ...

References

Tian R, Zheng F, Zhao W, Zhang Y, Yuan J, Zhang B, et al. Prevalence and influencing factors of nonunion in patients with tibial fracture: systematic review and meta-analysis. J Orthop Surg Res. 2020;15(1):377. DOI: https://doi.org/10.1186/s13018-020-01904-2

Newman SDS, Mauffrey CPC, Krikler S. Distal metadiaphyseal tibial fractures. Injury. 2011;42(10):975-84. DOI: https://doi.org/10.1016/j.injury.2010.02.019

Carter TH, Duckworth AD, Oliver WM, Molyneux SG, Amin AK, White TO. Open Reduction and Internal Fixation of Distal Tibial Pilon Fractures. JBJS Essent Surg Tech. 2019;9(3):e29. DOI: https://doi.org/10.2106/JBJS.ST.18.00093

Ronga M, Longo UG, Maffulli N. Minimally Invasive Locked Plating of Distal Tibia Fractures is Safe and Effective. Clin Orthop Relat Res. 2010;468(4):975-82. DOI: https://doi.org/10.1007/s11999-009-0991-7

Vidović D, Matejčić A, Ivica M, Jurišić D, Elabjer E, Bakota B. Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications. Injury. 2015;46:S96-9. DOI: https://doi.org/10.1016/j.injury.2015.10.067

Kundu AK, Phuljhele S, Jain M, Sahare KK. Outcome of Minimaly Invasive Plate Osteosynthesis (MIPO) Technique with Locking Compression Plate in Distal Tibial Fracture Management. Indian J Orthop Surg. 2015;1(3):138. DOI: https://doi.org/10.5958/2395-1362.2015.00015.8

Andalib A, Sheikhbahaei E, Andalib Z, Tahririan MA. Effectiveness of Minimally Invasive Plate Osteosynthesis (MIPO) on comminuted tibial or femoral fractures. Arch Bone Jt Surg 2017; 5(5):290-95.

Nabil A, Moawad M, Yassin I. Retrospective Study Evaluating The Results Of Minimally Invasive Plate Osteosynthesis (Mipo) In Management Of Distal Tibial Fractures. Al-Azhar Int Med J. 2020;1(7):69-72. DOI: https://doi.org/10.21608/aimj.2020.24430.1157

Kang H, Song JK, Rho JY, Lee J, Choi J, Choi S. Minimally invasive plate osteosynthesis (MIPO) for mid-shaft fracture of the tibia (AO/OTA classification 42): A retrospective study. Ann Med Surg. 2020;60:408-12. DOI: https://doi.org/10.1016/j.amsu.2020.11.033

Kneifel T, Buckley R. A comparison of one versus two distal locking screws in tibial fractures treated with unreamed tibial nails: a prospective randomized clinical trial. Injury. 1996;27(4):271-3. DOI: https://doi.org/10.1016/0020-1383(95)00116-6

Yang SW, Tzeng HM, Chou YJ, Teng HP, Liu HH, Wong CY. Treatment of distal tibial metaphyseal fractures: Plating versus shortened intramedullary nailing. Injury. 2006;37(6):531-5. DOI: https://doi.org/10.1016/j.injury.2005.09.013

Joveniaux P, Ohl X, Harisboure A, Berrichi A, Labatut L, Simon P, et al. Distal tibia fractures: management and complications of 101 cases. Int Orthop. 2010;34(4):583-8. DOI: https://doi.org/10.1007/s00264-009-0832-z

Borrelli J, Prickett W, Song E, Becker D, Ricci W. Extraosseous Blood Supply of the Tibia and the Effects of Different Plating Techniques: A Human Cadaveric Study. J Orthop Trauma. 2002;16(10):691-5. DOI: https://doi.org/10.1097/00005131-200211000-00002

Gupta P, Tiwari A, Thora A, Gandhi JK, Jog VP. Minimally Invasive Plate Osteosynthesis (MIPO) for Proximal and Distal Fractures of The Tibia: A Biological Approach. Malaysian Orthop J. 2016;10(1):29-37. DOI: https://doi.org/10.5704/MOJ.1603.006

Ranjan RK, Amaresh K, Bharat S, Rajeev A. To evaluate the functional result of distal tibia fractures treated with locking compression plates utilizing the minimally invasive plate osteosynthesis ( MIPO ) approach. Int J Life Sci Biotechnol Pharma Res. 2021;10(2):96-100.

Sönmez MM, Gülabi D, Uğurlar M, Uzun M, Sarban S, Şeker A. Minimal invasive fixation of distal tibial fractures does not result in rotational malalignment: A report of 24 cases with CT imaging. Ulus Travma Acil Cerrahi Derg. 2017;23(2):144-49. DOI: https://doi.org/10.5505/tjtes.2016.59153

Downloads

Published

2025-04-25

How to Cite

Magadum, M., Chitragar, D. D., Zalariya, S., & K. L., M. (2025). Clinical and radiological outcome of minimally invasive plate osteosynthesis in distal tibial fractures: a retrospective analysis. International Journal of Research in Orthopaedics, 11(3), 550–554. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251133

Issue

Section

Original Research Articles