Outcome of percutaneous locked plating of extra-articular distal tibial metaphyseal fractures

Abstract

Introduction: Management of fractures involving the distal tibial metaphysis is one of the most challenging and controversial issue due to poor soft tissue envelop. Multiple different fixation modalities are available with different outcome. Percutaneous plating of the distal tibia fracture is gaining more popularity due to minimal interruption of the fracture biology and favorable functional and radiological outcomes. Purpose: To evaluate the functional and radiological outcome of management of distal tibia extra articular metaphyseal fractures using locked plates with Minimally Invasive Plate Osteosynthesis (MIPO) technique. Methods: Twenty four patients with extra- articular distal tibia metaphyseal fractures were operated with locked compression plates using MIPO technique. They were followed up at regular intervals. Functional and radiological results were evaluated at the end of follow up. Results: All fractures united at average time of 12.21 weeks (range; 8-20 weeks). Postoperatively, two patients developed deep infection and two patients developed malunion. Mean AOFAS score was excellent 90.6 points (range: 52-100) at last follow up. Conclusion: MIPO technique using distal tibia locked plating is an effective procedure for fixation of distal tibia extra-articular metaphyseal fractures. It provides near anatomical fracture reduction with sufficient stability and preservation of the blood supply to the fracture fragments. It provides excellent functional results with acceptable rate of complications.