FUNCTIONAL OUTCOME OF MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS AMONG PATIENTS WITH PROXIMAL TIBIA FRACTURES

M SAEED; M INAM; SU HAQ

doi:10.54112/bcsrj.v2024i1.891

Authors

M SAEED Department of Orthopedic and Spine Unit, Hayatabad Medical Complex, Peshawar, Pakistan
M INAM Department of Orthopedic Department, Lady Reading Hospital, Peshawar, Pakistan
SU HAQ Department of Orthopedic and Spine Unit, Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.891

Keywords:

Fracture Fixation, Intramedullary, Fractures, Bone, Minimally Invasive Surgical Procedures, Tibia, Treatment Outcome

Abstract

Proximal tibia fractures are complex injuries that pose significant challenges in orthopaedic surgery. Minimally invasive percutaneous plate osteosynthesis (MIPPO) has been increasingly adopted as a treatment method due to its potential benefits in reducing soft tissue damage and promoting faster recovery. Objective: To assess the functional outcome of minimally invasive percutaneous plate osteosynthesis (MIPPO) among patients with proximal tibia fractures. Methods: A prospective cohort study was conducted in a tertiary care hospital over a period of two years, from January 2021 to December 2022. Thirty-five patients presenting with proximal tibia fractures were treated using the MIPPO technique. The Schatzker classification was used to categorize the fractures. Functional outcomes were assessed using the Knee Society Score (KSS) at six months postoperatively. Data were analyzed using descriptive statistics and chi-square tests to determine the significance of outcomes. Results: The most frequent type of fracture, according to Schatzker's classification, was type I, followed by type II and type III. An excellent outcome was observed in 21 patients (60%), good outcomes in 8 patients (22.9%), fair outcomes in 5 patients (14.3%), and poor outcomes in 1 patient (2.9%). Postoperative complications included infection in 2 patients (5.7%). Conclusion: Minimally invasive percutaneous plate osteosynthesis (MIPPO) is a safe and effective technique for managing proximal tibia fractures, yielding excellent functional outcomes in most patients.

Downloads

Download data is not yet available.

References

Ramponi DR, McSwigan T. Tibial plateau fractures. Advanced emergency nursing journal. 2018;40(3):155-61.

Trikha V, Gaba S, Agrawal P, Das S, Kumar A, Chowdhury B. CT based management of high energy tibial plateau fractures: A retrospective review of 53 cases. Journal of clinical orthopaedics and trauma. 2019;10(1):201-8.

Donovan RL, Smith JR, Yeomans D, Bennett F, Smallbones M, White P, et al. Epidemiology and outcomes of tibial plateau fractures in adults aged 60 and over treated in the United Kingdom. Injury. 2022;53(6):2219-25.

Agnew SG. Tibial plateau fractures. Operative techniques in orthopaedics. 1999;9(3):197-205.

Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. Instructional course lectures. 2008;57:25-36.

Hak DJ, Lee M, Gotham DR. Influence of prior fasciotomy on infection after open reduction and internal fixation of tibial plateau fractures. Journal of Trauma and Acute Care Surgery. 2010;69(4):886-8.

Borade A, Sanchez D, Kempegowda H, Maniar H, Pesantez RF, Suk M, et al. Minimally invasive plate osteosynthesis for periprosthetic and interprosthetic fractures associated with knee arthroplasty: surgical technique and review of current literature. The Journal of Knee Surgery. 2019;32(05):392-402.

Falez F, Papalia M, Carbone S, Teti A, Favetti F, Panegrossi G, et al. Low complication rates in Minimally Invasive Plate Osteosynthesis (MIPO) for proximal humeral fractures at 5 years of follow-up. Injury. 2019;50:S34-S9.

Wang B, Zhao Y, Wang Q, Hu B, Sun L, Ren C, et al. Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis. Journal of orthopaedic surgery and research. 2019;14:1-9.

Kim J-W, Oh C-W, Jung W-J, Kim J-S. Minimally invasive plate osteosynthesis for open fractures of the proximal tibia. Clinics in orthopedic surgery. 2012;4(4):313.

Wajnsztejn A, Pires RES, Dos Santos ALG, Labronici PJ, Fernandes HJA, Ferretti M. Minimally invasive posteromedial percutaneous plate osteosynthesis for diaphyseal tibial fractures: technique description. Injury. 2017;48:S6-S9.

Muzaffar N, Bhat R, Yasin M. Plate on plate technique of minimally invasive percutaneous plate osteosynthesis in distal tibial fractures, an easy and inexpensive method of fracture fixation. Archives of Trauma Research. 2014;3(3).

Sarmiento A, Latta LL. 450 closed fractures of the distal third of the tibia treated with a functional brace. Clinical Orthopaedics and Related Research®. 2004;428:261-71.

Janssen KW, Biert J, van Kampen A. Treatment of distal tibial fractures: plate versus nail: a retrospective outcome analysis of matched pairs of patients. International orthopaedics. 2007;31(5):709-14.

Im G-I, Tae S-K. Distal metaphyseal fractures of tibia: a prospective randomized trial of closed reduction and intramedullary nail versus open reduction and plate and screws fixation. Journal of Trauma and Acute Care Surgery. 2005;59(5):1219-23.

Aymen F, Youcef O, Aymen S, Issam A, Abderrazek A. Triplane fracture of the proximal tibia: a case report and literature review. Pan African Medical Journal. 2019;33(1).

Pulley BR, Gardner MJ. Bridge Plating of Proximal Tibial Metaphyseal Fracture by Limited Open Technique. Journal of Orthopaedic Trauma. 2019;33:S34-S5.

Wright DJ, Etiz B, Scolaro JA. Combined plate and nail fixation of bicondylar tibial plateau fractures. Injury. 2021;52(10):3104-10.

Gupta P, Tiwari A, Thora A, Gandhi J, Jog V. Minimally invasive plate osteosynthesis (MIPO) for proximal and distal fractures of the tibia: a biological approach. Malaysian orthopaedic journal. 2016;10(1):29.

Sandeep PK, Ramkumar MD, Ravi A, Kumar A, Subash Y. EVALUATION OF FUNCTIONAL OUTCOME OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS (MIPO) IN PROXIMAL TIBIA FRACTURES.