Minimally invasive percutaneous plate osteosynthesis for closed proximal tibia fractures: A study of 30 cases

Author(s): Dr. Arvind Kumar K and Dr. Arun Kumar Ramanathan

Abstract: Tibial plateau fractures comprises about one percent of all fractures and complex bicondylar fractures comprise of 30% of all Tibial plateau fractures. Minimally invasive percutaneous plate osteosynthesis [MIPPO] is a method of biological fixation where a plate is percutaneously inserted and fixed at a distance proximally and distally from the site of fracture. By minimal exposure, this aids in the protection of the essential fracture hematoma, minimal soft tissue dissection, avoidance of periosteal stripping and providing a sufficient fixation. So the need for the study is to assess the effectiveness of the technique in achieving fracture union, functional outcome and to know the rate of complications associated with MIPPO. The purpose of this study was to assess the results and the efficacy of MIPPO for of the proximal tibia fracture. This is a prospective study of 30 patients with tibial condylar fractures treated by minimally invasive percutaneous plate osteosynthesis at Karpaga vinayaga institute of medical sciences and research center, Chengalpattu, Tamil Nadu. These patients were followed both clinically and radiologically after surgical fixation. A total of 30 patients with tibial condylar fracture were included in the study. The mean age of the participants was 38.70±14.14 years, with 21 (70%) males and 9 (30%) females. In our study containing 30 patients operated by MIPPO, we had 66.67% had excellent result, 20% had good results, 6.67% had fair results and remaining 6.67% had poor results. In our study it was found that high velocity injuries (type IV – VI) have poorer outcome than low velocity injuries (type I-III). In this way cautious patient selection, careful preoperative planning, delicate and reasonable soft tissue and bone handling, precise contouring of plates and vigorous postoperative rehabilitation and patient education appears to be the key to success of the procedure.

DOI: https://doi.org/10.22271/ortho.2020.v6.i3g.2229