Abstract: Background: Management of distal tibial fractures remains one of the therapeutic Challenges. Mechanically stable fixation can be obtained without significant dissection and surgical trauma to the bone and soft tissues by Minimally invasive percutaneous plate osteosynthesis (MIPPO)
[1] Objectives: 1) To study and evaluate the clinical and radiological outcome of pilon A (Extra articular) fracture with MIPPO technique using LCP and also study the complications
Methodology: Patients of Bangalore medical college fulfilling inclusion & exclusion criteria be taken into study after informed written consent. Details including examination and investigations will be recorded in study Performa. MIPPO will be carried out depending on specific fracture pattern. Cases reviewed at 4,8,12 wks and 24 months both clinically and radiologically for bony union. Clinical outcome and Radiological criteria regarding fracture union and complications shall be documented. Functional outcome measured by LEFS score. Review of literature obtained and results compared with our study. Since these are proven methods of fixation, no control groups are required.
Results: Our study had 30 patients 19 male and 11 female. Average time for union was 16.4 weeks. Average time for full weight bearing was 18 weeks, 76 percent of our patients were back to previous work by 20 weeks. One patient had wound infection and his implant was removed and ex Fix applied, he needed plastic surgery intervention, and one patient had delayed union for Whom bone grafting was done by 10 weeks. 2 patients developed ankle stiffness.
Conclusion
1. Locking compression plate is a good system for Distal tibia (Pilon A) fractures.
2. As surgical dissection is minimum operating time is reduced.
LCP by MIPPO technique leads to less periosteal stripping and less softtissue damage, gives good angular stability and hence more rate of union and less chance of infection.
