Abstract: Background: Management of distal tibia fracture is challenging because of wound infections and poor wound healing due to precarious blood supply. Various methods of surgical treatment had been tried, such as closed intramedullary nailing, open reduction and internal fixation with conventional plate osteosynthesis and external fixation however most of them have a high complication rate than a good functional outcome. The newer technique of distal tibia fractures fixation using MIPPO involves less soft tissue handling and minimal periosteal stripping resulting in a lower infection rate and faster healing.
Materials and Methods: In this study, 25 patients with distal tibia extra articular fractures and intra articular fractures with or without associated fibula fractures were treated with MIPPO using medial LCP. The present study was conducted in the department of Orthopaedics at a tertiary care hospital and followed up for a period of 2 years.
Results: The mean follow up period ranged from 6 weeks to 2 years. All the fractures were united at an average of 16 weeks and mean AOFAS score at the end of 1 year was 85.64. There were two superficial wound infections which were treated with oral antibiotics and there was one deep infection and another with persistent ankle pain.
Conclusion: Minimally invasive percutaneous plate osteosynthesis is a reliable method of fixation not only extra articular, but also intra articular fractures of distal tibia. MIPPO technique for the distal tibia fractures offers a biological advantage by preserving the blood supply and decreases chances of delayed or non-union. Patients treated by MIPPO technique have a much lesser rate of deep infection and excellent radiological union. MIPPO technique helps in initiating early mobilization and reduces the risk of ankle stiffness.
