Proximal tibia being a prime component of knee joint, which is vital for weight bearing and mobility. Because of its superficial location and vulnerable position, proximal tibia is frequently injured, more frequently in road traffic accidents (RTA). With the better understanding of fracture healing, recent advances in tissue friendly minimally invasive techniques like MIPPO (Minimally Invasive Percutaneous Plate Osteosynthesis) and development of technically mature implant systems like LCP (Locking Compression Plate), which have shown promising results in the treatment of complex proximal tibial fractures, thus overcoming most of the drawbacks of conventional plating and other treatment modalities. The LCP is an internal fixator system, which is a hybrid of LC-DCP and LISS plate. The LCP can be applied in 3 different ways (1) As compression plate, (2) As combined compression and plating principle, and (3) As pure internal fixator (bridge plate).
Material and Methods: We studied 20 patients involving proximal tibial fractures fixed with LCP using MIPPO technique.
Results: We followed up all the patients for a period ranging from 16-36 weeks. The average time for union of fractures was 19 weeks ranging from 16-24 weeks. An average knee range of motion of 0-121º was achieved. In our study excellent results were achieved in 10 fractures (47.6%), good in 8 fractures (38.1%), fair in 2 fractures (9.6 %) while poor result was seen in one fracture (4.7 %). We had a total of 6 complications which included 2 knee stiffness, 1 post operative loss of reduction,1 infection, 1 varus deformity and 1 knee instability.
Conclusion: The patient sample approximately reflected the regular trauma patients encountered at our setup. The fractures treated with pure bridge plating and combined principle of compression and bridge plating healed rapidly by secondary fracture union, achieving strong union across the fracture site. In addition by MIPPO technique, there is minimal soft tissue damage and minimal disruption of blood supply to fracture ends, resulting in faster healing and fracture union.