The objective of this study is to evaluate the technique of surgical management distal tibial fractures treated by internal fixation with locking compression plates and screws through MIPPO.
Materials and Methods: In a prospective study conducted in the Postgraduate Department of Orthopaedics, Trichy SRM Medical College and Hospital, Trichy, Tamilnadu over a period of 2018 to 2020. 21 cases with distal tibial fractures and aged 18 to 65 years were included in this study. All fractures were classified under AO/ OTA ‘43’ classification. This included both intra articular (tibial plafond) fractures and extra articular where interlocking intramedullary nailing was not feasible or would produce rotational instability.
Results: A total of 21 patients were taken up for study. The age of patients in the study ranged from 18 to 65 Years with an average of 44.42 years at the time of surgery. With about 11 and 10 patients with the right and left sides involved respectively, both sides appear to be equally involved. Majority of the patients sustained injury due to RTA. Among the 21 patients, 15 had extra-articular fractures and 6 intra-articular fractures. 85% of the fractures united within 16 weeks with an average of 15.7 weeks. We experienced delayed unions in three patients possibly due to excess traction intra-operatively and due to comminution. Based on Tenny and Weiss scoring criteria for the ankle nineteen patients (90%) had good and excellent results at 22 weeks with fracture union.
Conclusion: The use of locking compression plate for intra and extra articular fractures of the distal tibia through minimally invasive technique along with fibular fixation is safe and effective.