FUNCTIONAL OUTCOME OF DISTAL TIBIA FRACTURES TREATED WITH LOCKING COMPRESSION PLATES USING MIPPO TECHNIQUE

Amit Yadav, Ali Saify, Dr. Ganesh Yeotiwad, Sagar G. Daliya, Pagadala Manikanta Babu

Abstract


Background:  The limited soft tissue, subcutaneous location of large portion of tibia and precarious blood supply renders the treatment of distal tibial fracture very challenging. Conventional osteosynthesis is not suitable because distal tibia is subcutaneous bone with poor vascularity. Closed Reduction and MIPPO with locking compression plate (LCP) has emerged as an alternative treatment option because it respects biology of distal tibia, maintains fracture haematoma and provides biomechanically stable construct, early mobilization, less complications and relatively higher rates of union.

Methods: 30 patients with distal tibia fracture with or without intra articular extension were treated with Closed Reduction and MIPPO with locking compression plate (LCP) Closed Reduction and. The patients were prospectively followed up for the duration of 12 months.

Results: There were 30 patients in the study including 22males and 8 females in the age group of 23 to 62 years (average 42years). The mean follow up period of our patients varied ranging from 6 months to 12 months. All fractures united at an average of 16 weeks (range- 12 to 20 weeks). In our study rate of superficial infection was 16.7% (5 patients), and ankle stiffness 6.7% (2 patients) .There were no cases of deep infection, delayed union, malunion or non union.

Conclusion: MIPPO with LCP is a reliable and effective method of treatment for the distal tibia fractures with or without intra articular extension, preserving most of the osseous vascularity and fracture haematoma and thus providing for a more biological repair. The use of indirect reduction technique and small incision is technically demanding as it is effective, minimally invasive, safe, optimises the operation time, reduces the incidence of infection, allows restoration of limb alignment and provides good clinical and radiological results with low complications and high union rates.


Keywords


distal tibia fracture, MIPPO, functional outcome, LCP)

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References


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