An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

Abstract

<p class="abstract"><strong>Background:</strong> Management of fractures of the distal tibia remains a challenging proposition due to the fact that the major part of the bone is in a subcutaneous location and the blood supply is quite precarious. Conventional forms of osteosynthesis are associated with high rates of infection and nonunion. Due to extensive soft tissue stripping, the vascularity is compromised and often results in poor wound healing and tends to compromise fracture healing as well. Closed reduction with minimally invasive plate osteosynthesis (MIPO) addresses these issues and has emerged as a viable treatment option with minimal complications. The aim of this study was to assess the functional outcome MIPO using locking compression plates (LCP).</p><p class="abstract"><strong>Methods:</strong> 32 patients with distal tibial fractures treated by MIPO technique with LCP fixation were studied from January 2012 to January 2014 and were followed up for a period of 2 years.<strong></strong></p><p class="abstract"><strong>Results:</strong> All the fractures in our series united well at the end of 6 months with mean time to radiological evidence of callus formation at 10 weeks and the mean time to fracture union was 20 weeks. There were 2 cases with varus angulation in our series and no cases with implant failure. There were 3 patients with superficial skin infections and no cases of deep infection.</p><p><strong>Conclusions:</strong> We conclude that MIPO with LCP is an effective treatment option for distal tibial fractures avoiding all the complications associated with other forms of internal fixation. We strongly recommend its usage in these types of complex injuries.</p>

Comparision of Distal Uniplanar Locking with Biplanar Distal Locking in Intramedullary Interlocking Nailing of Fractures Distal Shaft of Tibia

“…5 Improved intramedullary nail designs offering enhanced stability and minimal invasive plate osteosynthesis (MIPO) using locking compression plates help avoid the associated complications. 10,11 The present study results were similar to Alemdaroğlu et al, (2019). They reported that union time is significantly reduced by locking the distal end with three biplanar screws.…”

“…9 This biplanar three screw construct provides enhanced stability than the uniplanar two screw construct, which is expected to shorten the union time of the distal shaft of tibia fractures. 10 Therefore, it is hypothesised that biplanar distal interlocking using three interlocking screws provides a more stable construct, and the early union is achieved in distal diaphyseal tibia fractures. The current study was planned to compare union times in patients managed with uniplanar distal locking to patients managed with biplanar distal locking using a reamed intramedullary interlocking nail for fractures distal shaft of the tibia.…”