Study of distal tibial extra-articular fractures fixed with locking compression plate using MIPO technique

Abstract

Background: Fractures of distal tibial metaphysis present a management challenge because of their inherent instability, scarcity of soft tissue, subcutaneous nature and poor vascularity of bone. MIPO techniques are advantageous because of limited soft tissue strapping, maintenance of the osteogenic fracture haematoma without interrupting vascular supply to the individual fracture fragments. Materials and Methods: This is a study of 20 patients of closed extra articular distal tibial fractures treated with anatomical LCP applied on antero-medial surface of lower end tibia with MIPO technique. Age was ranging from 20 to 60 yrs. 14 male and 6 female patients were there. 7 patients were having fibula fracture at same level of tibia fracture, they were fixed with DCP/ 1/3 tubular plate before fixing tibia. Results: AO/OTA type 43 A1 fractures were there in 15 patients. 4 pts. were having 43 A2 and one pt. was having 43 A3 type fracture. Average operation time was 80 mins. Average union time was 18.5 weeks. One pt. was having delayed union, one having superficial skin infection, one having 6* varus angulation and one having malleolar skin irritation. No pts. required second surgery of bone grafting. No implant failure. Conclusion: MIPO with LCP is a reliable and effective method of treatment for the distal tibial extra-articular fractures, preserving most of the osseous vascularity and fracture haematoma and thus providing a more biological repair. Using indirect reduction technique and small incision is technically demanding. Keywords: Anatomical LCP, Distal tibial fractures, MIPO.