scholarly journals Comparative study between intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis for distal tibia extra-articular fractures

2021 ◽  
Author(s):  
Kapil Mani KC ◽  
Bandhu Ram Pangeni ◽  
Suman Babu Marahatta ◽  
Arun Sigdel ◽  
Amuda KC
Keyword(s):  
Minimally Invasive ◽  
Comparative Study ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Interlocking Nailing ◽  
Articular Fractures

scholarly journals Comparative study between intramedullary interlocking nailing and minimally invasive percutaneous plate osteosynthesis for distal tibia extra-articular fractures

2021 ◽  
Vol 7 (6) ◽  
pp. 1177
Author(s):  
Anil Sharan ◽  
Johney Juneja ◽  
Raghvendra Choubisa ◽  
Nitin Jeenjwadia ◽  
A. K. Mehra ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Comparative Study ◽  
Plate Osteosynthesis ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Tibia Fractures ◽  
Group A ◽  
Distal Tibia Fractures ◽  
Group B

<p class="abstract"><strong>Background: </strong>Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage. There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis (MIPPO) technique and intramedullary interlocking (IMIL) nailing for extra-articular distal tibia fractures. The aim of our study is to compare the functional outcome between the two treatment methods.</p><p class="abstract"><strong>Methods:</strong> This was the prospective comparative study of 50 patients with distal third tibia fractures divided into two groups. First group of patients were treated with MIPPO technique while second group of patients were managed by IMIL nailing. Patients were followed up in outpatient department to assess the functional outcomes, malunion, delayed union, non-union, superficial and deep infection between the two groups.</p><p class="abstract"><strong>Results: </strong>Average time taken by patients for full weight bearing in group A was 17.6 weeks as compared to 16.7 weeks in group B. All patients were able to bear weight prior to complete union of fracture. By the process of weight bearing, we believed that it would promote secondary bone healing. On taking X-rays during follow up of included patients starting of radiological union was observed carefully by looking for bridging callus, haziness of fracture line. Appearance of callus was taken average time of 12.5 weeks in group A and 12.1 weeks in group B.</p><p class="abstract"><strong>Conclusions: </strong>Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue, bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing. Considering the results of the study, we have slightly more preference for the MIPPO technique.</p>

scholarly journals A comparative study of locking plate by minimally invasive percutaneous plate osteosynthesis versus closed interlocking intramedullary nail in extra-articular distal tibia fractures

2021 ◽  
Author(s):  
Jojin Jose Chitten ◽  
R. Balasubramaniam
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Small Sample Size ◽  
Distal Tibia ◽  
Small Sample ◽  
Articular Fractures ◽  
Tibia Fractures ◽  
One Year

<p><strong>Background</strong>: To compare functional outcome between minimally invasive percutaneous plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMIL) in the distal one-third extra-articular tibia fracture.</p><p><strong>Methods</strong>: We retrospectively analysed 32 patients with closed distal tibia extra-articular fractures who underwent IMIL nail and locking plate MIPO technique in 16 patients each. All patients were followed for at least one year with assessment of clinico-radiological union and functional outcome scoring.</p><p><strong>Results</strong>: There was comparable functional outcomes, time to union and surgical time both in IMIL nail and MIPO fixation of closed distal extra-articular tibia fractures with similar complication rate.   </p><p><strong>Conclusions</strong>: Our study suggests that both IMIL nail and MIPO fixation could be used for closed distal extra-articular tibia fractures as per surgeon’s preference. However, due to small sample size in our study, we cannot draw any definitive conclusions from our preliminary results but consider them as valuable basis for future studies.</p>

Minimally Invasive Plate Osteosynthesis Using Locking Plates for AO 43–Type Fractures: Lessons Learnt From a Prospective Study

2017 ◽  
Vol 11 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Rajeev Shukla ◽  
Nikhil Jain ◽  
Ravi Kant Jain ◽  
Shravan Patidar ◽  
Vivek Kiyawat
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Surgical Trauma ◽  
Locking Plates ◽  
Soft Tissue Dissection ◽  
Tibia Fractures ◽  
Radiological Union

Introduction. Managing fractures of distal tibia is still a subject of debate for orthopaedic surgeons in terms of both, reduction and fixation. Subcutaneous location and soft tissue anatomy predisposes it to angular and rotational instability as well as other bony and soft tissue complexities. Minimally invasive plating offers many advantages over conventional open techniques. It causes minimal soft tissue dissection and surgical trauma to the bone. Minimally invasive plate osteosynthesis(MIPO) maintains biological configuration of distal tibia and fracture hematoma and also provides a construct, which is biomechanically more stable. Objectives. Evaluation of results of MIPO in management of distal tibia fractures considering radiological union, ankle function restoration, and complications. Materials and Methods. In our study, 25 closed distal one-third tibia fracture with/without articular extension were taken, fulfilling the inclusion criteria (AO classification: 10, 43A1; 3, 43A2; 2, 43B1; 4, 43B2; and 6, 43C1). MIPO with locking plates was the treatment undertaken. Patients were followed up for 18 months prospectively. Results. Average injury-hospital interval was 11.16 hours and average injury-operation interval was 2.44 days. All fractures showed radiological union at an average duration of 20.5 weeks (14-28 weeks). Olerud and Molander score was used for evaluation at 3, 6, and 18 months. One patient had union with valgus angulation >5° but there was no nonunion. There was 1 superficial postoperative wound infection. Conclusion. Our study shows that plating with MIPO is an effective treatment for closed distal one-third tibia fractures, considering union time and complications rate. Younger age promotes early union and functional recovery. Levels of Evidence: Therapeutic, Level II: Prospective

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>

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