J Korean Fract Soc.  2008 Oct;21(4):286-291. 10.12671/jkfs.2008.21.4.286.

A Comparison between Minimally Invasive Plate Osteosynthesis & Interlocking Intramedullary Nailing in Distal Tibia Fractures

• Lee KB
• Song SY
• Kwon DJ
• Lee YB
• Rhee NK
• Choi JH

• KMID: 1480917
• DOI: http://doi.org/10.12671/jkfs.2008.21.4.286

Abstract

PURPOSE: To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and interlocking IM nailing in the treatment of distal tibia fracture without involvement of ankle joint retrospectively.
MATERIALS AND METHODS
38 patients with distal tibia fracture from Jan. 2004 to Oct. 2005 were divided into two groups. Minimum follow-up was for 12 months. Group MIPO consisted of 18 patients were treated with MIPO and group Nail consisted of 20 patients were treated with interlocking intramedullary nail. The results were compared between two groups by assessing bony union time and operation time. Clinical evaluation was evaluated by Olerud score.
RESULTS
The mean bony union time was 14.4 weeks (12~17 weeks) in group MIPO and 16.7 weeks (13~19 weeks) in group Nail (p=0.011). The mean operation time was 1.05 hours (0.6~1.6 hours) in group MIPO and 0.74 hours (0.4~1.1 hours) in group Nail (p=0.044). The Olerud score was 83.8 (75~100) in group MIPO and was 89.6 (70~100) in group Nail (p=0.075). In Complication, group MIPO showed one metal failure and two skin irritations, group Nail showed three superficial wound infections.
CONCLUSION
MIPO was the shorter bony union time and the longer operation time than the interlocking intramedullary nailing. There were no significant differences between the two groups in clinical results.

Keyword

Distal tibia fracture; Minimally invasive plate osteosynthesis (MIPO); Interlocking intramedullary nailing

MeSH Terms

Ankle Joint
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Nails
Skin
Tibia

Figure

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  Fig. 1 (A) The initial radiographs of 60 year-old female show distal fracture without involvement of ankle joint (AP & Lateral view). (B) The clinical photo shows the insertion of LCP DMP through subcutaneous tunnel of the distal tibia and fixation of the plate with screws. (C) Bone union was obtained in 15 weeks after LCP DMP with interfragmentary fixation (AP & Lateral view).

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  Fig. 2 (A) The initial radiographs of 54 year-old male show distal fracture without involvement of ankle joint (AP & Lateral view). (B) Bone union was obtained in 16 weeks after interlocking IM nail fixation (AP & Lateral view).

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  Fig. 3 The patient had a good bone union and excellent function, but complained skin irritation around medial aspect of ankle joint even if we used the Locking Compression Plate Distal Medial Tibia Plate (LCP DMT).

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