Functional Outcome Of Minimally Invasive Plate Osteosynthesis (Mipo) In Proximal Tibial Fractures – A Hospital Based Prospective Cohort Study

Abstract

Background:

A hospital based prospective cohort study was done to evaluate the results of proximal tibia fractures managed with minimally invasive plate osteosynthesis (MIPO) and assessed for time for bony union, functional outcome and complications of the said procedure.

Methods: A one-year hospital based prospective cohort study was conducted; which included a total of 30 patients who presented to the Emergency Department, OPD/IPD of the Department of Orthopaedics and met the inclusion criteria which were enlisted in the study. The functional outcome of Minimally Invasive Plate osteosynthesis (MIPO) using locking and non-locking compression plates in tibial condyle fractures were evaluated. The data was compiled & analysed using Sanders 40 Point.

Results: Fractures of proximal tibia were more prevalent in the younger and middle-aged population with mean age range 21-60 years. All the 30 fractures analysed were graded in accordance to the schatzker classification with 16 cases of type 1, 5 cases of type 2, 4 cases of type 3, 2 cases of type 4, 1 case of type 5 and 2 cases of type 6 fractures. In our study Males were more commonly affected than females (24 males and 6 females). About 70% of the fractures were due to high velocity trauma. In Schatzker type 5 and 6 fractures MIPO technique did not show good results and thus dual plating was done in 2 (6.67%) cases. The mean time to union was 14.6 weeks, with 54% of fractures uniting in 14 – 16 weeks. Complication in the form of infection was observed in 2 (6.67%) cases. There were 2 (6.67%) cases of collapse of the reduced fracture and 2(6.67%) cases of malunion. In type 5 and type 6 fractures MIPO alone was insufficient and we observed that these fractures required dual plating. Sanders’s score was applied to analyze the functional outcome of our cases. After evaluation it was observed that 83% of patients had good to excellent performance. Four patients had fair results and one performed poorly. The average range of motion of the knee joint was 0° to 120°.

Conclusion: Minimally Invasive Plate Osteosynthesis (MIPO) is a good technique to stabilize the fractures of the proximal tibia (Intra Articular) with minimal soft tissue dissection, preservation of the fracture haematoma and early range of motion, thus facilitating patients in early recovery and active participation in rehabilitation programme.