scholarly journals EVALUATION OF FUNCTIONAL OUTCOME OF DISTAL TIBIAL FRACTURES STABILIZED WITH DISTAL TIBIAL LOCKING PLATE

Author(s):  
Sumeet Verma ◽  
Rakesh Thakur

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: The patients attending the OPD/Emergency OPD in post graduate institute of medical education and research, chandigarh during September 2018 to August 2019 with distal tibial fractures. The patients treated with locking compression plates using MIPO or ORIF are reviewed for inclusion and exclusion criteria’s. Patients fitting into inclusion criteria has formed the study group. Results: Out of 52 patients, 48.4% patients undergo open reduction internal fixation had excellent results and 28.6% patients undergo MIPPO technique had excellent results. p value is 0.352 which is not significant. Overall 40.4% patients had excellent results. Conclusion: We observed excellent/ good functional outcome in 65.3% of patients. Keywords: Functional outcome, MIPPO, Tibia

Author(s):  
Naveen Kumar ◽  
Manoj Thakur ◽  
Sandeep Kashyap

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods: </strong>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.</p><p class="abstract"><strong>Results: </strong>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.</p><p class="abstract"><strong>Conclusions: </strong>We observed excellent/ good functional outcome in 65.3% of patients.</p>


2017 ◽  
Vol 17 (2) ◽  
pp. 18-22
Author(s):  
Nabees Man Singh Pradhan ◽  
JA Khan ◽  
B Acharya ◽  
S Shrestha ◽  
R Tamrakar ◽  
...  

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


2014 ◽  
Vol 20 (1) ◽  
pp. 44-49
Author(s):  
Șerban Al. ◽  
Obadă B. ◽  
Turcu R. ◽  
Anderlik St. ◽  
Botnaru V.

ABSTRACT Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours) open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68). The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks). All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks) showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.


Author(s):  
Yeshwanth Subash ◽  
Prabhu Manickam S. ◽  
Ravikrishna R. ◽  
Priyadarshini S. ◽  
Gunalan K. Naidu

<p class="abstract"><strong>Background:</strong> 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).</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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.</p>


2021 ◽  
pp. 1-3
Author(s):  
Kunal Shankar ◽  
Vikash M. Harinandan ◽  
Laljee Chaudhary ◽  
Debarshi Jana

Background: The fractures of distal tibia including tibial pilon pose a great challenge to the surgeon due to subcutaneous location, scarcity of blood supply and paucity of soft tissue coverage. Minimal invasive plating osteosynthesis (MIPO) has evolved as a newer concept to treat distal tibial fractures with minimal articular comminution and minimal soft tissue damage. Aim of the present study was to evaluate the results of MIPO technique with use of a locking plate in fracture tibia distal end. Method: During the study period of two years, total 45 cases of closed distal tibial fractures (Diaphyseal and metaphyseal region) were operated by MIPO technique with a distal tibial anatomical locking plate (3.5 and 4.5 mm). They were followed up at regular intervals and results were evaluated. Results: The age of the patients ranged from 20-60 years with the majority (19; 42.22%) of them being in the age of 40-50 years. The most common mode of injury was road traffic accident (33; 73.33%). In all patients MIPO was performed, in none of them, fracture site was opened. Mobilization of adjacent joints was carried out mostly from second to fourth postoperative day. Most of the fractures united between 10-12 weeks (26; 57.77%). On analyzing the results of MIPO, excellent results were seen in 66.66% cases and 33.34% had satisfactory results. Conclusion: Hereby we concluded that though various modalities of treatment of fractures of the distal tibia are present MIPO seem to be better technique if done under skillful guidance as done in this study.


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