Comparison study of two surgical options for distal tibia fracture—minimally invasive plate osteosynthesis vs. open reduction and internal fixation

Abstract

The aim of this study was to compare the results between two surgical options for distal tibia fracture, i.e. minimally invasive plate osteosynthesis (MIPO) vs. open reduction and internal fixation (ORIF), and explore the benefits and defects of these two techniques. Thirty cases of distal tibia fracture (15 pairs of ORIF and MIPO) were submitted for pair comparison with consistence of gender, age and AO fracture classification. Indexes for evaluation included operative time, blood loss, healing time, time of recovery to work, implant irritation symptoms, and union status. Mazur grading standard was introduced for functional evaluation. Statistical Package for Social Sciences (SPSS) 13.0 was used for analysis. No malunion occurred and one case of osteomyelitis developed in the ORIF group. In the ORIF group, ten cases were evaluated as excellent, three as good, one as fair and one as poor. In the MIPO group, ten cases were excellent and five good. Paired t-test found no significant differences between groups on the indexes for analysis. In conclusion, the MIPO technique is not distinctively superior to ORIF in treatment of distal tibia fracture.

Treatment of distal tibial shaft fractures by three different surgical methods: a randomized, prospective study

“…Aksekili et al [30], in a study treating 35 distal and diaphyseal tibial fractures with the MIPO technique, suggested that MIPO is an effective treatment for tibial diaphysis and distal tibia fractures with low complication and high union rates. High primary union rate (90.5 %) and only one patient with nonunion was observed in the MIPO group in our study, which is consistent with other studies [8,[30][31][32]. Although we found the irritation symptoms were more frequently encountered in the MIPO group, the symptoms had no effect on their daily life.…”

“…The highest infection rate is seen in patients treated with open reduction and internal fixation. MIPO, intramedullary nail and external fixation lead to a serious decrease in the infection rates [5,6,15,31,35,36]. Results from this present study show that deep infection does not have a significant difference between the three groups.…”

Surgical treatment of distal tibia fractures: Open versus MIPO?

“…[2,3] Fracture pattern (proximity of the fracture to the plafond, comminution), soft tissue injury, and bone quality critically influence the selection of the fixation technique. [4] A variety of treatments may be used, including external fixation, intramedullary nailing, and plate fixation. [1,5] tal, and was approved by the Local Ethical Committees, dated and numbered 11.02.2014-89513307/1009/255, of the same hospital.…”

Minimally invasive plate osteosynthesis of distal tibial fracture using a posterolateral approach: a cadaveric study and preliminary report

“…The current standard treatment of this fracture is staged surgery using an MIPO technique in order to minimise further soft-tissue damage, preserve the periosteal blood supply and increase the rate of fracture healing [11,12]. A number of studies have reported good results with an MIPO technique using both anteromedial and anterolateral approaches in treating these fractures [11][12][13][14][15][16][17][18][19][20]. Furthermore, we demonstrate the use MIPO for distal tibial fractures through a posterolateral approach in terms of anatomical safety and also report a case with an excellent outcome.…”

“…Minimally invasive plate osteosynthesis (MIPO) of distal tibial fractures using an anteromedial or anterolateral approach has been popular in recent years, with satisfactory clinical outcomes, as this method has less soft-tissue disruption with preservation of fracture haematoma and blood supply to the bone fragments [11][12][13][14][15][16][17][18][19][20]. However, using a posterolateral approach with the MIPO technique in distal tibial fractures has not been previously reported in the literature.…”