MIPO vs. intra-medullary nailing for extra-articular distal tibia fractures and the efficacy of intra-operative alignment control: a retrospective cohort of 135 patients

2022 ◽  
Author(s):  
Nils Jan Bleeker ◽  
Nicole M. van Veelen ◽  
Bryan J. M. van de Wall ◽  
Inger N. Sierevelt ◽  
Björn-Christian Link ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Distal Tibia ◽  
Medullary Nailing ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

scholarly journals A comparative study of low multidirectional locked nailing and locking compression plating in management of distal tibia fractures

2018 ◽  
Vol 4 (6) ◽  
pp. 830
Author(s):  
Balakrishna Pinnaka ◽  
Shankarlinga S. ◽  
K. Ramachandra Kamath ◽  
Rajashekar Danda ◽  
M. Girish Raju
Keyword(s):  
Distal Tibia ◽  
Treatment Modalities ◽  
Multiple Treatment ◽  
Fracture Management ◽  
Medullary Nailing ◽  
Tibia Fractures ◽  
Group A ◽  
Distal Tibia Fractures ◽  
Diaphyseal Fractures ◽  
Group B

<p class="abstract"><strong>Background:</strong> Ideal management for distal tibial meta-diaphyseal fracture remains controversial, due to lack of adequate evidences about implants and multiple treatment modalities. Most commonly these fractures were dealt with either locking compression plate (LCP) or by multi directional intra-medullary nail (IMIL). Aim is to compare these two implants, to understand the mechanism and find out the ideal implant for the management of distal tibia fractures.</p><p class="abstract"><strong>Methods:</strong> This study is prospective and comparative done at the associated hospitals of KMC Mangalore, spanning a period of around 2 years (October 2014 to July 2016). All patients presented with distal tibial meta-diaphyseal fractures were included in the study. Patients were treated with either low multi directional IMIL nail or by LCP and followed up for a minimum period of 6 months. Outcome measures included Olerud Molander Ankle Score (OMAS), wound issues, union of the fracture and patient mobility.<strong></strong></p><p class="abstract"><strong>Results:</strong> 50 consecutive patients (mean age 40 years) were included in the study, divided equally into 2 groups. Group-A treated with multi directional IMIL nail and group-B with MIPPO plating. Mean functional OMAS score for nailing is 91 and for plating is 88. All fractures treated with nailing united within 6 months and 4% patient treated by plating goes mal union and 4% infected.</p><p class="abstract"><strong>Conclusions:</strong> For distal tibial fracture management, intra-medullary nailing proved reliable surgical option with regards to the OMAS score, fracture union and less infection rates.</p>

Percutaneous ORIF of Periarticular Distal Tibia Fractures, Perspective 2

2015 ◽  
pp. 1-7
Author(s):  
Francesco Oliva ◽  
Rodrigo Buharaja ◽  
Alessio Giai Via ◽  
Nicola Maffulli
Keyword(s):  
Distal Tibia ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

scholarly journals Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

2018 ◽  
Vol 24 (1) ◽  
pp. 66-71
Author(s):  
Kawalkar Abhijit Chandrakant ◽  
Badole Chandrashekher Martand
Keyword(s):  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Early Weight Bearing ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

scholarly journals Functional outcome of minimally invasive plate osteosynthesis with the use of locking plate in fracture distal end of tibia

2020 ◽  
Vol 6 (6) ◽  
pp. 1239
Author(s):  
Prashant Kamble ◽  
Nandan Marathe ◽  
Sudhir Sharan ◽  
Ayush Sharma ◽  
Ashwin Sathe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Locking Plates ◽  
X Rays ◽  
Functional Scores ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

<p class="Body"><strong>Background : </strong>Distal tibia fractures or pilon fractures are usually the result of combined compressive and shearing forces, which may lead to instability of the metaphysis. Poor vascularity, lack of muscle cover and frequent intra-articular extension often make these fractures very challenging to manage. There are plenty of options available to treat a distal tibia fracture which includes intramedullary nailing, external fixation, open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO). The aim of this study was to evaluate the results of MIPO with respect to the healing of fracture site, the incidences of complications and to conclude whether MIPO circumvents the problems of formal open reduction and fixation with other implants.</p><p class="Body"><strong>Methods: </strong>A series of forty patients with fracture of the distal tibia on preoperative X-rays were treated with minimally invasive plate osteosynthesis using pre-contoured locking plates from June 2014 to October 2018 and followed up at regular intervals with X-rays and monitoring for complications.</p><p class="Body"><strong>Result: </strong>The functional scores were evaluated using Teeny and Wiss clinical rating system for ankle joints. Thirty-two patients had an ‘Excellent’ or ‘Good’ outcome. One patient was diagnosed with a soft tissue complication and delayed union and 3 patients were diagnosed with malunion without significant functional disability at follow up. <strong></strong></p><p class="Body"><strong>Conclusion: </strong>Minimally invasive plate osteosynthesis with pre-contoured locking plates is associated with high union rate and good functional outcomes. It is an effective treatment modality for distal tibia fractures.</p>

scholarly journals Extra-articular distal tibia fibula fracture managed with single posterolateral approach: a case report

2021 ◽  
Vol 7 (3) ◽  
pp. 683
Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G. S. ◽  
Tushar C. Patil ◽  
Kartik P. Pande ◽  
Harish Pawar
Keyword(s):  
Distal Tibia ◽  
Posterolateral Approach ◽  
Anterolateral Approach ◽  
Ankle Motion ◽  
Fibula Fracture ◽  
Left Ankle ◽  
Alternative Approach ◽  
Soft Tissue Problems ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

<p class="abstract">Extra-articular distal tibia fractures involve distal tibia approximately 4 cm within tibia plafond with no articular extension. The proper preoperative care, planning and selection of surgical approach is very essential to prevent postoperative wound-related complications. We present a case of a 29 year female patient, presented with left ankle pain and swelling with a wound over the medial aspect of the ankle. X-ray of the left ankle showed extra-articular distal tibia fibula fracture with no neurovascular deficit. We managed both the fractures with open reduction and internal fixation using a single posterolateral approach. At present 1 year follow-up, the patient is having a good range of ankle motion with radiological union with no implant failure and wound-related complications. Extra-articular distal tibia fibula fracture fixation using single posterolateral approach is a viable alternative approach to medial or anterolateral approach in cases of medial or anterior soft tissue problems. It helps in getting a better functional outcome, early mobilisation with less wound-related complications.</p>

Sign in / Sign up

Export Citation Format

Share Document