MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS WITH DISTAL TIBIAL ANATOMICAL PLATE FOR DISTAL TIBIAFRACTURE

Abstract

Background: Management of distal Tibial fractures is therapeutically challenging, because of its unique anatomic subcutaneous location with precarious blood supply and proximity to the ankle joint, leading to the potential for postoperative complications and poor outcome.

Methods: Twenty five patients with closed distal Tibia fracture without intra articular extension (AO classification: 43A1, 43A2, 43A3) treated with MIPO with Distal Tibial Anatomical Plate were prospectively followed for duration of 6 months

Results: Mean pre-operative delay was 8.56 days and mean duration of surgery was 66.36 minutes. Mean total hospital stay was 14 days composed of mean admission to surgery & post-operative stay of 8 and 10 days respectively. In 68% cases radiological union was achieved within an average duration of 18 weeks while 20% had union at 12 weeks & remaining 12% had union at 24 weeks of follow-up. There were four superficial and two deep post-operative wound infection. All infections healed with extended period of intravenous antibiotics. Three patients suffered from ankle stiffness. 64% of total patients had Excellent result according to Oleur and Mollander functional score while 28% had Good result & 8% had Fair result at the end of 6 months of follow-up.

Conclusion: The present case study shows that MIPO with Distal Tibial  Anatomical Plate is an effective treatment method in terms of union time and complications rate for distal Tibiafracture. Malleolar skin irritation is common problem because of prominent hardware.