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Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures

Purpose. To review the outcomes of 53 patients who underwent minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures. Methods. Medical records of 31 men and 22 women aged 22 to 78 (mean, 51) years who underwent MIPO using a locking compression plate for distal tibial fractures of the left (n=28) and right (n=25) legs with or without intra-articular extension were reviewed. Results. Patients were followed up for a mean of 26 (range, 24–38) months. The mean time from injury to surgery was 9 (range, 3–12) days. The mean operating time was 105 (range, 75–180) minutes. The mean hospital stay was 16 (range, 8–25) days. Non-weight bearing walking with a crutch was started after a mean of 5.7 (range, 3–9) days. The mean time to callus formation was 12 (range, 8–15) weeks. The mean time to full weight bearing was 15 (range, 8–22) weeks. The mean time to bone union was 25 (range, 20–30) weeks. All except 2 fractures united anatomically. At 10 months, the range of motion of the ankle joint in all patients was similar to the contralateral side. Two patients had malunion but this was not clinically significant. Five patients had superficial infection, and 2 patients had persistent pain. Conclusion. MIPO is effective for closed, unstable fractures of the distal tibia. It reduces surgical trauma and preserves fracture haematoma.