Bridging-minimally invasive locking plate osteosynthesis (Bridging-MILPO): technique description with prospective series of 20 tibial fractures.

Bridging-MILPO provides an alternative to other internal and external devices in the management of tibial fractures. A pre-contoured, stainless steel locking compression plate (Synthes) is fed subcutaneously through a small incision from a site distant to the zone of injury across the fracture site, respecting the fracture haematoma. Two or three locking screws are placed specifically at the ends of the plate. This 'spring leaf' like construct allows micro-motion at the fracture site. This induces callus formation, initially on the opposite cortex from the plate, accelerated by the allowance of immediate full weight bearing post-operatively. Twenty cases were performed over a 3-year period. Excellent final results were obtained in 19 out of the 20 cases. Complications included two superficial wound infections, one delayed union and one case needed revision plating. No loss of reduction was seen in any of the cases.