A Study of Minimally Invasive Percutaneous Plate Osteosynthesis with Locking Compression Plate for Distal Tibial Fractures

Abstract

Introduction: Distal tibial fractures present a serious challenge, often requiring operative treatment but are very difficult to deal with. Fixation with locking compression plate (LCP) by minimally invasive percutaneous plate Osteosynthesis (MIPPO) technique has emerged as an alternative treatment option because it respects biology of distal tibia and fracture hematoma and also provides biomechanically sound fixation. The aim of this study was to find out the results of MIPPO with LCP for distal tibial fractures in our set up. Method: Twenty nine patients were treated by minimally invasive technique (MIPPO with LCP) for distal tibial fracture, only 24 patients were having proper follow-up. These 24 patients-(AO classification: 14 type A, 5 type B & 5 type C) were prospectively followed up. Twenty two male and two female patients with a mean age of 35 years were included. Results: In our study 17 (70.83%) patients had excellent results, 6(25%) patients had good results & 1(4.17 %) patient was having poor result. One patient had delayed union & required bone grafting. Malleolar skin irritation and pain due to prominent hardware was observed in two patients. One patient had hardware failure due to non-compliance. Another patient had infection in fibular fixation site that required hardware removal. Conclusion: The MIPPO technique for distal tibia has shown good results with many additional advantages over the conventional methods. It appears to be a reliable & effective method of stabilisation for these fractures. Rigid fixation allows the patient to be mobilized earlier & complications like displacement, contractures & stiffness can be avoided.