Distal Tibial Fractures – Surgical outcome following Minimally Invasive Percutaneous Plate Osteosynthesis

Abstract

With preservation of the vascularity of the bone, preservation of the soft tissue envelope and containment of the fracture haematoma, minimally invasive procedures provide fixation in a biologically sound manner. With these in view, this study was conducted to evaluate the technique of surgical management in distal tibial fractures treated by internal fixation with locking compression plate (LCP) and screws through the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. In this cohort study, 21 patients with distal tibial fractures who were admitted to the hospital between November 2014 and August 2016 were tracked for at least 10 weeks and up to 39 weeks. Adults who were fit enough for surgery, both male and female, participated in the study. MIPPO procedures were followed for every case. In this investigation, a total of 21 cases were examined. Eighty-six per cent of cases with proper bone union were able to bear their full weight at or before the 18-week mark. Complete weight bearing was permitted for the final three patients (14%) at or before 39 weeks. Ninety per cent of patients had fracture union rates that were satisfactory to excellent at 23 weeks. Also, delayed unions were noted in three individuals; two cases experienced ankle stiffness, one as a result of prolonged immobilisation and the other as a result of an intra-articular fracture. There were no infections or wound breakdowns during this trial. The MIPPO technique with LCP plates is a good choice when intramedullary nailing is inadequate for metaphyseal and distal tibia shaft fractures. Also, early fracture union is easily accomplished using the MIPPO technique and careful application of these plates.