A hospital based assessment of the clinical and radiological outcome of extra-articular metaphyseal proximal tibia fractures treated with proximal tibia plates using MIPPO technique using Rasmussen’s scoring system

Abstract

Aim: To assess the clinical and radiological outcome of extra-articular metaphyseal proximal tibia fractures treated with proximal tibia plates using the MIPPO technique using Rasmussen’s scoring system. Materials and Methods: Data related to demographics, mechanism of injury, details of trauma, hospitalization detail, operation description, post-operative rehabilitation, complications, clinical and functional outcomes were collected during the period of hospital stay and follow-up visits in the OPD clinic. Follow-up was conducted regularly at the interval of 4 weeks. The patients were followed up in the outpatient department. At the follow-up, a thorough clinical and radiological evaluation was done for the progress of union, healing of trauma wound, and joint stiffness. Once the fracture had shown early signs of union, partial weight bearing was started on the injured limb. On follow up, the patients were evaluated clinically and radiologically according to the proforma decided (Modified Rasmussen’s criteria for clinical and Radiological evaluation). Results: Majority (83.34%) of the patients in our study were males between the age group of 21-60 years. 90% of the patients had high energy proximal tibia fractures, which were caused by road traffic accidents (RTA) with a peak incidence in the fourth and fifth decade of life. Total 5 patients developed a superficial infection which was resolved by daily dressings and parenteral antibiotics. Rasmussen’s score was applied to assess functional and radiological outcomes. In our study, according to Rasmussen’s clinical scoring, 66.67% of patients had excellent, 12% of patients had well and 10% of patients had fair results. In our study, according to Rasmussen’s radiological scoring, 80% of patients had excellent and 20% of patients had good results. Conclusion: MIPPO is a relatively new concept in fracture management; but with the improved instrumentation and implants, it has the potential to become one of the mainstays of fracture management in the years to come.