J Korean Fract Soc.  2010 Jan;23(1):42-49. 10.12671/jkfs.2010.23.1.42.

Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture

• Shon OJ
• Kim DS

• KMID: 1461571
• DOI: http://doi.org/10.12671/jkfs.2010.23.1.42

Abstract

PURPOSE
To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a lateral plate (Zimmer, Periarticular Lateral Distal Tibial Plates, USA) in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.
MATERIALS AND METHODS
From January 2005 to December 2007, 15 patients with distal tibial fracture treated by MIPPO technique using a lateral plate were analyzed. The duration of follow-up was more than 1 year. We evaluated union time by simple X-ray, clinical results by IOWA ankle rating system, and complication.
RESULTS
The bone union was achieved in all cases at average 16.7 weeks. Evaluation of the ankle function test showed an average of 90.3 points, resulting in satisfactory. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection.
CONCLUSION
We concluded that MIPPO technique using a lateral plate is a efficient method for high functional recovery with good bone healing and low complication in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.

Keyword

Distal tibial fracture; Minimally invasive percutaneous plate osteosynthesis (MIPPO); Lateral plate

MeSH Terms

Animals
Ankle
Congenital Abnormalities
Follow-Up Studies
Humans
Iowa
Tibial Fractures

Figure

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  Fig. 1 (A) The initial film shows a comminuted fracture of the distal tibia with medial open wound. (B) Lateral plate was inserted anterolaterally through mini skin incision. (C) The location and size of plate was verified by C-arm. (D) Postoperative radiograph shows satisfactory position of plate and screws.

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  Fig. 2 (A) A 64 year old man sustained a right distal tibial fracture (AO/OTA type 43, A3) with medial open wound after traffic accident. (B) First, lateral malleolar fracture was fixed using MIPPO technique, and bridge external fixator was applied. (C) After 3 weeks, lateral plate fixation of distal tibia using MIPPO technique was performed, and postoperative radiograph at 1 year after the injury shows solid bony union and satisfactory alignment.

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  Fig. 3 (A) A 38 year old man sustained an intraarticular fracture of right distal tibia (AO/OTA type 43, C1) after traffic accident. (B) Medial open wound was showed. (C) First, lateral malleolar and tibial intraarticular fracture were fixed, and bridge external fixator was applied. (D) After 1 week, lateral plate fixation of distal tibia using MIPPO technique was performed, and postoperative radiograph shows satisfactory alignment.

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