Closed Distal Tibia Fractures in Adults: The Outcome of Locking Plate Through the MIPO Technique
Abstract
Objective: To study the functional outcome of lock plates in distal tibia fractures through the MIPO (minimally invasive plate osteosynthesis) technique, in Mardan Medical Complex, Mardan.
Background: Fixing the distal tibia is a difficult job for an orthopedic surgeon for two reasons; technical difficulty in holding the distal fragment and bulk of soft tissue over the anteromedial surface of the tibia. The use 3.5 mm locking plate through MIPO techniques solves both these problems with good clinical and radiological outcomes.
Methods: This prospective study (consecutive case series) was conducted on a total of 45 patients from June 2018 to December 2021. Adult Patients with isolated distal tibia fractures consented to lock plate (3.5mm) fixation through the MIPO technique after fulfilling the inclusion criteria. The fracture was classified according to the AO/OTA system. The mean delay from injury to operation was 6 days (0-8). Patients were followed up from 9 months to 24 months with a mean follow-up of 19 months. At last follow-up data was recorded. Functional results were graded according to the Olerud-Molander functional evaluation score (OMFS).
Results: The total number of patients who underwent locking plate fixation through the MIPO technique is 45, with a mean age of 55 years (22-88) at the time of surgery. The mechanism of injury was road traffic accidents (47%) in most of the cases followed by falls from height (36%). All fractures united at an average of 19 weeks (15-24) with acceptable length and alignment, except in two cases that united at 26 weeks. No complications like deformities, compartment syndrome, non-union, implant irritation/skin impingement, or implant failure were seen in our study. Functional results were graded according to the Olerud-Molander functional evaluation score (OMFS), 47 % were excellent, 44% were good, 7% were fair and 2% were poor.
Conclusion: MIPO is a safe alternative to conventional ORIF in achieving union for plating fracture of the distal tibia. Its functional outcomes are good with the least soft tissue dissection and complications associated with conventional open reduction.
KEYWORDS: Distal tibia fracture, MIPO technique, locking plate, indirect reduction
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Copyright (c) 2024 Khalid Khan, Tariq Ahmad, M Arsalan Azmat Swati, Rahim khan, Abu Saeed
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