Siddhartha Venkata Paluvadi1, Hitesh Lal2, Deepak Mittal3, Kandarp Vidyarthi4. 1. Senior Resident, Department of Orthopaedics, PGIMER & Dr. RML Hospital, New Delhi 110001, India. 2. Consultant and Assistant Professor, Department of Orthopaedics, PGIMER & Dr. RML Hospital, New Delhi 110001, India. 3. Consultant, Professor and Head of the Department, Department of Orthopaedics, PGIMER & Dr. RML Hospital, New Delhi 110001, India. 4. Consultant Orthopaedic Surgeon, Gurgaon, India.
Abstract
BACKGROUND: Minimally invasive plate osteosynthesis (MIPO) is an established technique for fixation of fractures of the distal third tibia. Our study aimed to manage intra articular and 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. Though many studies on the subject have been done previously, these have been retrospective reviews or small series. METHODS: From May 2010 to May 2013, 50 patients of closed distal tibial fractures were operated by MIPO technique with a distal tibial anatomical locking plate having 4.5/5 proximal and 3.5/4 distal screw holes. The follow up duration was for 3 years. RESULTS: The mean fracture healing time was 21.4 weeks (range 16-32 weeks) and average AOFAS score 95.06 was out of a total possible 100 points. At last follow up, superficial infection occurred in 5 patients (10%); deep infection, implant failure and malunion in 1-patient each (2%). CONCLUSION: MIPO technique provides good, though slightly delayed bone healing and decreases incidence of nonunion 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 comminuted fractures and in fractures with intra-articular extension.
BACKGROUND: Minimally invasive plate osteosynthesis (MIPO) is an established technique for fixation of fractures of the distal third tibia. Our study aimed to manage intra articular and 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. Though many studies on the subject have been done previously, these have been retrospective reviews or small series. METHODS: From May 2010 to May 2013, 50 patients of closed distal tibial fractures were operated by MIPO technique with a distal tibial anatomical locking plate having 4.5/5 proximal and 3.5/4 distal screw holes. The follow up duration was for 3 years. RESULTS: The mean fracture healing time was 21.4 weeks (range 16-32 weeks) and average AOFAS score 95.06 was out of a total possible 100 points. At last follow up, superficial infection occurred in 5 patients (10%); deep infection, implant failure and malunion in 1-patient each (2%). CONCLUSION: MIPO technique provides good, though slightly delayed bone healing and decreases incidence of nonunion 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 comminuted fractures and in fractures with intra-articular extension.
Authors: Sean E Nork; Alexandra K Schwartz; Julie Agel; Sarah K Holt; Jason L Schrick; Robert A Winquist Journal: J Bone Joint Surg Am Date: 2005-06 Impact factor: 5.284
Authors: Mohammadreza Minator Sajjadi; Adel Ebrahimpour; Mohammad A Okhovatpour; Amin Karimi; Reza Zandi; Amir Sharifzadeh Journal: Arch Bone Jt Surg Date: 2018-09