Minimally invasive percutaneous plate osteosynthesis (MIPPO) in treatment of distal meta-physeal fractures of tibia: A study on Complications

Abstract

Biological' internal fixation avoids the need for precise reduction, especially of the intermediate fragments, and takes advantage of indirect reduction. This principle applies equally to locked nailing, bridge plating, and internal fixator-like devices. Indirect reduction aims only to align the fragments. It avoids exposure of the bone thus reducing the surgical trauma. Flexible fixation is advocated to induce formation of callus and is achieved by using wide bridging of the area of the fracture. The patients were followed up at intervals of three weeks for up to 6-10 months to assess the radiological union. After the 1st follow up of 4 weeks patient is allowed to partially bear weight. The fracture was designated as united, when there was periosteal bridging callus at the fracture site at least in three cortices in the anteroposterior and lateral views. Trabeculations extending across the fracture site was also taken into consideration. Partial and full weight bearing were allowed. Two of the patients developed superficial skin infections, which were treated with daily dressings and appropriate antibiotics according to the culture and sensitivity reports. All the infections subsided on the above said treatment. We had 1 patient with ankle stiffness. Probably due to the lack of compliance to the advised physiotherapy at home after discharge of the patient. Ankle stiffness ranged from restriction of ankle movement from 20-40%.