A PROSPECTIVE STUDY OF MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS USING LOCKING COMPRESSION PLATE FOR MANAGEMENT OF DISTAL TIBIAL FRACTURES

Dr. Amit Gupta

Volume : X, Issue : V, May - 2020

A PROSPECTIVE STUDY OF MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS USING LOCKING COMPRESSION PLATE FOR MANAGEMENT OF DISTAL TIBIAL FRACTURES

Dr. Amit Gupta

Abstract :

BACKGROUND: MIPPO is an established technique for fixation of distal tibia fracture. Our study aimed to evaluate MIPPO using locking compression plate in treatment of distal tibial fractures with regards to time for fracture union, functional outcome and intra–operative and post–operative complications. METHODS: This is a prospective type of study in which 36 patients admitted at GMC kota, from Oct 2018 to Sept 2019 with distal tibia fractures were included. Patients were surgically managed by closed reduction and internal fixation with minimally invasive percutaneous plate osteosynthesis (MIPPO) using LCP .All patients were evaluated clinically and radiologically before and following surgery, for an average period of follow up of 6 months. Result: The fractures united in 32 (88.8%) patients before 20 weeks while in 4 (11.2%) patients it took upto 24 weeks.11(30.6%)patient had excellent,16(44.4%)had good,5(13.9%) had fair and 4(11.1%) had poor results according to Modified AOFAS ankle hindfoot Scale.Post–operatively, 5 patients developed superficial skin infection and 2 patients developed ankle stiffness due to loss of post operative physiotherapy protocol.Good amount of range of motion of ankle joint was present in almost all patients. CONCLUSION: MIPPO technique provides adequate stability to maintain the reduction and thus allow early motion. It facilitates early union as it also preserves blood circulation to the fracture fragments.The greatest advantage with MIPPO is that fracture haematoma is not disturbed much. It is also effective in extra articular fractures occurring within 5cm of the joint where intramedullary nails do not provide enough stability.Even though this technique has steep learning curve, newer anatomically contoured locking compression plates for the distal end tibia fractures has reduced surgical time in both extra articular and intra articular fractures.