Functional outcome of Tibial condyle fractures treated by minimally invasive plate osteosynthesis

Objective. The aim of this study was to compare the functional outcome and complications in midshaft clavicle fractures receiving minimally invasive plate osteosynthesis and conventional open plating. Methods. Relevant studies were searched in the databases of Medline, EMBASE, Cochrane Library, Ovid, and Web of Science from inception to March 1, 2019. Pooled data were analyzed with Cochrane Collaboration’s Review Manager 5.3. Results. A total of 7 studies were included, of which 2 were randomized controlled trials, 3 were retrospective cohort studies, and 2 were prospective cohort studies including 316 patients. No statistical differences in functional outcome (weighted mean difference [WMD] = 0.99, P=0.12), operation time (WMD = −10.44, P=0.07) and time to bone union (WMD = −0.23, P=0.70) were observed between the two groups. However, minimally invasive plate osteosynthesis reduced rates of skin numbness (odds ratio (OR) = 0.25, 95% CI : 0.13 to 0.48; P<0.0001) and complications (OR = 0.33, 95% CI : 0.16 to 0.71; P=0.005) compared with conventional open plating. Conclusion. This systematic review and meta-analysis found no differences in terms of functional outcomes, operation time, and fracture healing time between minimally invasive plate osteosynthesis and conventional open plating. However, minimally invasive plate osteosynthesis had apparent advantages in rates of skin numbness and complications.

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Radiological parameters determining outcome in pilon fractures treated by minimally invasive plate osteosynthesis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191790 ◽

2019 ◽

Vol 5 (3) ◽

pp. 490

Author(s):

Vishnu Sankar Appusamy ◽

Karthik Ramachandran ◽

Arvind Manoj Kumbakrishnakumar

Keyword(s):

Minimally Invasive ◽

Functional Outcome ◽

Soft Tissues ◽

Plate Osteosynthesis ◽

Soft Tissue Injury ◽

Minimally Invasive Plate Osteosynthesis ◽

Surgical Trauma ◽

Radiological Parameters ◽

Pilon Fractures

Background: Tibial pilon fractures are one of the challenging fractures to manage in the field of orthopaedics due to its complex fracture patterns as well as associated soft tissue injury. Minimally invasive plate osteosynthesis (MIPO) technique aims to reduce the surgical trauma to the surrounding soft tissues and hence maintain a more biologically favourable environment for fracture healing. The purpose of the study is to analyse the various factors especially radiological parameters determining functional outcome in pilon fractures treated by MIPO technique.Methods: This is a prospective study conducted from June 2015 to May 2018. The study included 46 patients (33 males, 13 females) with pilon fractures treated by minimally invasive plate osteosynthesis. All patients were followed for average period of 2 years. Functional outcome was assessed using American Orthopedic Foot and Ankle Score (AOFAS).Results: Among 46 patients, 21 patients (45.65%) had excellent, 16 patients (34.78%) had good and 6 patients (13.04%) had fair functional outcome. The quality of reduction was the most important parameter determining the functional outcome. We found that patients with higher lateral distal tibial angle (LDTA), anterior distal tibial angle (ADTA) and length of lateral malleolus (LLM) had better functional outcome than patients with lower values. The timing of surgery had no significant influence on the functional outcome of the patients.Conclusions: We like to conclude that apart from the quality of fracture reduction, radiological parameters like ADTA, LDTA, and LLM also play a crucial role in determining the functional outcome in pilon fractures.

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Comparative study of functional outcome of minimally invasive plate Osteosynthesis versus open reduction and internal fixation with locking compression plate in distal 1/3rd shaft tibia fractures (Extraarticular)

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2019.v5.i4c.1664 ◽

2019 ◽

Vol 5 (4) ◽

pp. 149-152

Author(s):

Dr. Sanjeev Sreen ◽

Dr. Girish Sahni ◽

Dr. Sanjeev Kumar ◽

Dr. Ayush Kumar Jain ◽

Dr. Tarun Behl

Keyword(s):

Minimally Invasive ◽

Comparative Study ◽

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Locking Compression Plate ◽

Minimally Invasive Plate Osteosynthesis ◽

Compression Plate ◽

Tibia Fractures

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Prospective study of clinical, radiological and functional outcome of anterior bridge plating for shaft of humerus fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20204592 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1245

Author(s):

Abhishek Kumar ◽

Rahul Bade

Keyword(s):

Los Angeles ◽

Minimally Invasive ◽

Internal Fixation ◽

Functional Outcome ◽

Road Traffic ◽

Plate Osteosynthesis ◽

Treatment Protocol ◽

Minimally Invasive Plate Osteosynthesis ◽

Bridge Plating

Background: Shaft of humerus (SOH) fracture has been conventionally treated with either open reduction internal fixation with plate osteosynthesis or immobilization as conservative treatment. Intramedullary interlocking nailing (IMIL) and anterior bridge plating (ABP) are both newer modalities of internal fixation for SOH fracture. Rotator cuff irritation is a known complication of IMIL nailing of the humerus. Here, we present clinical, radiological, and functional outcome of SOH fracture fixation by ABP using a minimally invasive method.Methods: Thirty patients with SOH fracture were treated surgically via an anterior minimally invasive plate osteosynthesis (MIPO) approach with ABP. There were 21 male and 9 female patients, and the average age was 38.6±10.45 years. The mechanism of injury was road traffic accidents (60%) and ground level fall (40%). Functional assessments were obtained with University of California at Los Angeles (UCLA) score and mayo elbow performance index (MEPI) during the follow-up period.Results: At the end of 6 months follow-up, 29 (96.7%) patients had excellent to good UCLA and MEPI scores. Varus/valgus angulation was reported in 4 (13.3%) patients. Two patients (6.7%) had radial nerve neuropraxia and delayed union, while 1 (3.3%) patient had screw back-out or loosening. The mean duration of radiation exposure was 178±41.2 seconds. ABP for SOH fractures is a safe and effective treatment modality.Conclusions: This treatment protocol produces high rates of union, excellent functional recovery, and minimal biological disruption.

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An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174696 ◽

2017 ◽

Vol 3 (6) ◽

pp. 1136

Author(s):

Yeshwanth Subash ◽

Prabhu Manickam S. ◽

Ravikrishna R. ◽

Priyadarshini S. ◽

Gunalan K. Naidu

Keyword(s):

Minimally Invasive ◽

Functional Outcome ◽

Treatment Option ◽

Plate Osteosynthesis ◽

Distal Tibia ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Distal Tibial Fractures ◽

Superficial Skin ◽

Mean Time

Background: Management of fractures of the distal tibia remains a challenging proposition due to the fact that the major part of the bone is in a subcutaneous location and the blood supply is quite precarious. Conventional forms of osteosynthesis are associated with high rates of infection and nonunion. Due to extensive soft tissue stripping, the vascularity is compromised and often results in poor wound healing and tends to compromise fracture healing as well. Closed reduction with minimally invasive plate osteosynthesis (MIPO) addresses these issues and has emerged as a viable treatment option with minimal complications. The aim of this study was to assess the functional outcome MIPO using locking compression plates (LCP).Methods: 32 patients with distal tibial fractures treated by MIPO technique with LCP fixation were studied from January 2012 to January 2014 and were followed up for a period of 2 years.Results: All the fractures in our series united well at the end of 6 months with mean time to radiological evidence of callus formation at 10 weeks and the mean time to fracture union was 20 weeks. There were 2 cases with varus angulation in our series and no cases with implant failure. There were 3 patients with superficial skin infections and no cases of deep infection.Conclusions: We conclude that MIPO with LCP is an effective treatment option for distal tibial fractures avoiding all the complications associated with other forms of internal fixation. We strongly recommend its usage in these types of complex injuries.

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Clinico-Radiological and functional outcome of anterior bridge planting with minimally invasive plate osteosynthesis (MIPO) in diaphyseal fracture humerus: A Prospective Study

Journal of Bone and Joint Diseases ◽

10.13107/jbjd.2020.v35i02.018 ◽

2020 ◽

Vol 35 (2) ◽

pp. 30-35

Author(s):

Amit Saraf ◽

Vakul Mahipal ◽

Najmul Huda

Keyword(s):

Minimally Invasive ◽

Prospective Study ◽

Functional Outcome ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

Diaphyseal Fracture ◽

Fracture Humerus ◽

A Prospective Study

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Evaluation of functional outcome of distal tibial fractures stabilized with distal tibial locking plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205022 ◽

2020 ◽

Vol 7 (1) ◽

pp. 39

Author(s):

Naveen Kumar ◽

Manoj Thakur ◽

Sandeep Kashyap

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Open Reduction Internal Fixation ◽

Tibial Fractures ◽

P Value ◽

Minimally Invasive Plate Osteosynthesis ◽

Distal Tibial Fractures

Background: The present study is an attempt to evaluate the results of locking compression plate for distal tibia in lower tibial fractures using open reduction internal fixation and minimally invasive plate osteosynthesis technique.Methods: Prospective and retrospective study was conduct on patients attending the outpatient department (OPD)/Emergency OPD in Indira Gandhi Medical College, Shimla during September 2015 to August 2016 with distal tibial fractures. The patients treated with locking compression plates using minimally invasive plate osteosynthesis (MIPO) or open reduction internal fixation (ORIF) are reviewed for inclusion and exclusion criteria. All data were collected and analyzed by Epi-info software.Results: Out of 52 patients, 48.4% patients undergo open reduction internal fixation had excellent results and 28.6% patients undergo surgery by MIPPO technique had excellent results. p value is 0.352 which is not significant. Overall, 40.4% patients had excellent results. In our study, 32.6% patients having AO/OTA type A fractures had excellent score while type B and C had 1.9% excellent score. This is attributed to more comminution and involvement of ankle joint. Overall, 40.4% patients had excellent score. P value is 0.863 which is insignificant.Conclusions: We observed excellent/ good functional outcome in 65.3% of patients.

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