scholarly journals Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) For Proximal Tibial Fractures

2017 ◽  
Vol 2 (5) ◽  
Author(s):  
Hemant H. Mathur ◽  
Keval D. Parmar
Keyword(s):  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Tibial Fractures ◽  
Proximal Tibial Fractures

scholarly journals To analyze the functional outcome of proximal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis technique

2017 ◽  
Vol 3 (6) ◽  
pp. 1205
Author(s):  
Sivakumar Arumugam ◽  
Venkateshwara Arumugam ◽  
V. Raviraman
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Tibial Plateau ◽  
Plate Osteosynthesis ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Tibial Fractures ◽  
Soft Tissue Dissection ◽  
Proximal Tibial Fractures ◽  
Walking Capacity

<p class="abstract"><strong>Background:</strong> Tibial plateau fractures constitute about 1% of all fractures and complex bicondylar fractures constitute 30% of all Tibial plateau fractures. Minimally Invasive Percutaneous Plate Osteosynthesis [MIPPO] is a method of biological fixation in which a plate is percutaneously inserted and fixed at a distance proximally and distally from the fracture site. By minimal exposure, this helps in the preservation of the essential fracture hematoma, minimal soft tissue dissection, avoidance of periosteal stripping and providing an adequate fixation. The objective of the study was to analyze the functional outcome of proximal Tibial fractures treated with MIPPO technique. The method of fixation shall be evaluated for the time period required for the patients to return to active work following surgery.</p><p class="abstract"><strong>Methods:</strong> In our study, all 18 patients with proximal Tibial fractures underwent definitive fixation by MIPPO technique. All our cases underwent initial stabilization as per the ATLS guidelines. Patients with closed Tibial plateau fractures associated with a tense haemarthrosis underwent aspiration of the joint under aseptic precautions. The limb was immobilized either in an above knee slab or through skeletal traction using a distal Tibial or calcaneal pin traction on a Bohler Braun splint until definitive fixation was carried out. In cases complicated with excessive swelling and blistering, definitive fixation was delayed until the swelling/ blistering subsided.<strong></strong></p><p class="abstract"><strong>Results:</strong> The post-operative results were designated as excellent, good, fair and poor according to pain, walking capacity, the range of motion and stability of the knee using Rasmussen’s grading system. In our study, the average functional knee score was 22.89. Rasmussen’s score does not consider articular congruity while assessing the functional outcome of the knee.</p><p class="abstract"><strong>Conclusions:</strong> MIPPO technique gives good to excellent results even in high energy Tibial condyle fractures [72.22% cases in our study]. Our patients were able to achieve a good functional range of movement, averaging 120 degrees. [Krettek et al – 124 degrees]. Those who were treated with early fixation and early mobilization were found to have a better functional outcome irrespective of the fracture type. No secondary bone grafting was required. </p>

scholarly journals A prospective study to analyse the outcome of locking compression plating by minimally invasive percutaneous plate osteosynthesis technique in proximal tibial fractures

2018 ◽  
Vol 4 (3) ◽  
pp. 442
Author(s):  
Anjaneyulu Reddy D. ◽  
Krishna Redy P.
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Plate Osteosynthesis ◽  
High Energy ◽  
Tibial Fractures ◽  
Articular Fractures ◽  
Tibial Condyle ◽  
Proximal Tibial Fractures ◽  
Compression Plating ◽  
Osteosynthesis Technique

<p class="abstract"><strong>Background:</strong> The proximal tibial fractures are one of the commonest intra articular fractures majority are of high energy fractures. We did the study to measure the outcome of locking compression plating by minimally invasive percutaeneous plate osteosynthesis technique in proximal tibial fractures.</p><p class="abstract"><strong>Methods:</strong> Study comprises 20 cases of proximal tibial fractures, which have been managed by MIPPO technique during the period December 2014 to August 2016.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sex distribution in our study was 18 males and 2 females with 30 to 57 years age. The most common mode of injury in this study was road traffic accident. Type V Schatzker tibial plateau fractures were the commonest in 8 patients. 70% of our patients had excellent and good results in the functional outcome. In our study the average functional knee score was 22.40. The average range of movement achieved was 120 degrees. The average time taken for fracture healing was 16.52 weeks. In conclusion, MIPPO technique gives good to excellent results even in high energy tibial condyle fractures (70% cases in our study). Those who were treated with early fixation and early mobilization were found to have a better functional outcome irrespective of the fracture type. No secondary bone grafting was required.</p><p class="abstract"><strong>Conclusions:</strong> The study reports that MIPPO technique is an effective method of treating proximal tibial fractures due to its overall good functional outcome.</p><p class="abstract"> </p>

Staged minimally invasive plate osteosynthesis of proximal tibial fractures with acute compartment syndrome

Injury ◽  
2017 ◽  
Vol 48 (6) ◽  
pp. 1190-1193 ◽  
Author(s):  
Joon-Woo Kim ◽  
Chang-Wug Oh ◽  
Jong-Keon Oh ◽  
Hee-Soo Kyung ◽  
Kyeong-Hyeon Park ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Compartment Syndrome ◽  
Plate Osteosynthesis ◽  
Acute Compartment Syndrome ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Proximal Tibial Fractures

scholarly journals Outcome of minimally invasive plate osteosynthesis in distal tibial fractures

2017 ◽  
Vol 17 (2) ◽  
pp. 18-22
Author(s):  
Nabees Man Singh Pradhan ◽  
JA Khan ◽  
B Acharya ◽  
S Shrestha ◽  
R Tamrakar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Type I ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
The Mean

Introduction: Distal tibial fractures present as a major challenge for the orthopedic trauma surgeons. Most non-operative treatments result in non-union or malunion and needs prolonged immobilization of the knee and ankle joints, with resulting stiffness. Open reduction and internal fixation as well as external fixation has high rate of infection and non-union. Minimally Invasive Plate Osteosynthesis has been shown to have a better outcome and has been the procedure of choice in most distal tibial fractures since the introduction of the locking compression plate. The objective of the study is to review the outcome of Minimally Invasive Percutaneous Osteosynthesis (MIPO) in unstable distal tibial fractures.Methods: Charts of patients who underwent MIPO from the year 2008 to 2013 for unstable distal tibial fractures over five years at Patan Hospital and Om Hospital were reviewed. All displaced closed fractures and Gustillo Anderson Type I and II fractures were included in the study. Plates consisted of the anatomically contoured 4.5 mm LCP and 3.5 mm LCP-Pilon form plate. A simple uniplanar external fixator was used to retain the reduction till the plate was inserted and secured with locking screws. The outcome of MIPO in distal tibial fractures were followed up and evaluated.  Clinical and radiological assessments were performed at 6 weeks, and at 3, 6, 9, 12 and 24 months.Results: Of the 75 patients (45 male, 30 female) age ranging from 19 to 70 years (mean 47 years), 5 patients were lost to follow-up. 28 patients at 3 months, 32 at 6 months, and 8 at 9 months met the criteria for a healed fracture. Two patients required autologous bone grafting at 9 months for non-union ultimately resulting in the fracture union at 16 months. There was one malunion attributable to the loss of reduction during plate fixation. There were no deep infections, no soft tissue complications and no failures of fixation. The cause of fracture were RTA (n=35), fall from height (n=9), twisting of ankle as a result of fall from standing height (n=22), and others (n=11). The mean time for surgery from the time of injury was 5 (range, 2 to 14) days; the mean hospital stay was 10 (range, 7 to 21) days.Conclusion: MIPO is an effective treatment for closed, unstable fractures of the distal tibia, avoiding the complications associated with more traditional methods of internal fixation and/or external fixation.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 7-11

scholarly journals Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Bo Wang ◽  
Yang Zhao ◽  
Qian Wang ◽  
Bin Hu ◽  
Liang Sun ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Functional Outcomes ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Deep Infection ◽  
Tibial Fractures ◽  
Low Risk ◽  
Wound Complications ◽  
Distal Tibial Fractures ◽  
Randomized Controlled

Abstract Background The treatment for distal tibial fractures remains controversial to date. Minimally invasive percutaneous plate osteosynthesis (MIPPO) and intramedullary nailing (IMN) are well-accepted and effective methods for distal tibial fractures, but these methods were associated with complications. This study aimed to assess and compare the clinical and functional outcomes in patients with distal tibial fractures treated with MIPPO or IMN. Methods We systematically reviewed randomized controlled trials (RCTs) that compared MIPPO with IMN in patients with distal tibial fractures from inception till 15 August 2019. Also, quantitative summaries of time to reunion, rate of complications, and functional outcomes were evaluated. Results The pooled results suggested that patients in the MIPPO group had a longer time to reunion with a mean difference of 1.21 weeks [P = 0.02; 95% confidence interval (CI) 0.16–2.26)] than those in the IMN group. The overall union complications and deep infection between IMN and MIPPO were similar (P > 0.05). IMN had a significantly low risk of wound complications [risk ratio (RR) = 0.51, P = 0.00, 95% CI 0.34–0.77)]. The pooled functional outcomes of the two groups remained controversial by different evaluating scores. Conclusions Compared to MIPPO, IMN had a significantly low risk of wound complications and associated with limited time for reunion. Although the pooled functional outcomes of the two groups were controversial due to different evaluating scores, IMN was the preferred surgical technique than MIPPO for treating distal tibial fractures.

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