Abstract: Background: Distal tibial fractures, also known as Pilon fractures constitute about 5 to 10 percent of the tibial fractures. These fractures are difficult to manage. MIPO (Minimal invasive plating osteosynthesis) technique is indicated for fractures with minimal articular comminution and the fractures where soft tissue envelops is minimally damaged. It works on Biological Fixation Principle, in which blood supply to the fracture fragments is maximally preserved.
Aim: The purpose of this retrospective study is to evaluate the outcome of MIPO for distal tibial fracture.
Design: This is a single center retrospective study conducted between 2016 and 2019 in a Tertiary Care Hospital (Medical College Hospital).
Method: 19 patients of distal tibial fracture operated with MIPO technique using pre-contoured metaphyseal LCP (locking compression plate) were analyzed retrospectively. Fractures were classified as per AO system and patients were followed and scored according to TEENY and WISS clinical scoring criteria.
Result: Among 19 patients operated, there were 14 males and 5 females with a mean age of 41.32years (ranging from26-66yrs). 16 patients sustained extra-articular fractures (type A), 02 partial-articular fractures (type-B) and 01 total-articular fracture (type C). High energy trauma (road traffic accident) predominated causing 13 fractures. Average trauma surgery interval was 10 days (02-16 days). Patients were followed, minimum for 01 year (range 1 -4 years). Surgical wound breakdown with implant exposure was seen in 01 case. Based on Teeny and Wises clinical rating system, all except one patient had an ‘Excellent’/good outcome.
Conclusion: MIPO is an effective and safe technique for the management of distal tibial fractures without intra-articular comminution and minimum soft tissue damage. It preserves bone biology by maintaining balance between revascularization and mechanical perfection. Further studies with longer follow-up and large sample size are warranted.
