A study of results of surgical management of distal tibia fractures treated by mippo tehnique with locking compression plate

Author(s): Dr. Vijaya Shankar and Dr. Kathir Azhagan S

Abstract: Background and objectives: The surgical treatment of fractures according to AO principles has seen a change in the past decade, from anatomical reduction and rigid fixation to the current concept of Biological fixation, precise reduction being a goal only in intra-articular fractures. With the advent of internal fixators like PC-Fix and LISS (Less Invasive Stabilizing System) this was being achieved to some extent. The recent development of LCP has revolutionized the treatment by overcoming the few drawbacks of these internal fixators. The LCP is a screw plate system that offers the possibility of inserting conventional and locking head screws into the specially designed combination holes. We aimed to study the nature of fracture union in fractures treated with LCP by MIPO technique and to analyse any complications arising out of this technique. Methods: This is a retrospective study of 23 cases of distal tibia fracture (19 patients had associated fibula fracture) admitted in Southern Headquarter Railway Hospital, Chennai, between March 2006 and November 2009. Cases were taken according to inclusion and exclusion criteria. We treated all patients with LCP by MIPO technique. Results: We followed up all the patients and the duration ranged from 13 weeks to 38 weeks (mean 18.9 weeks). All fractures eventually united including 2 which had delayed union. Rest of the 21 fractures united at a mean of 20 weeks. We had totally 6 complications which included superficial infection (1), deep infection (2), iatrogenic fracture (1) and delayed union (2). We had no case of any purely implant related complications like screw loosening, screw breakage, plate failure. Interpretation and conclusion: The patient sample approximately reflected the regular trauma patients encountered at our set up. Fractures treated with MIPO, healed rapidly by secondary fracture union and hence achieving strong bony union across the facture site. With the LCP system the biological fixation of fractures was easier than the conventional plates. The anchorage of locking head screws even in osteoporotic bone was excellent. We also confirmed its proven efficacy in the treatment of difficult fracture situations, where in other implants have limited application. Fresh conclusions cannot be drawn as sample size is not sufficient.

DOI: https://doi.org/10.22271/ortho.2019.v5.i2i.67