Prospective study of distal tibia fracture with anterolateral plating by MIPPO technique

The management of distal Tibia fractures has been a great challenge to orthopaedic surgeons due to soft tissue damage, extensive comminution, intra-articular extension and lack of vascularity.

Twenty five adult patients treated by anterolateral 3.5mm distal Tibial LCP by MIPPO technique between December 2014 and July 2016 were included in the study. The radiological outcome was assessed by Tenny and Wiss score and the functional outcome by AOFAS scale.

Of the 25 patients in the study, 18 were males and 7 were females. The mean age was 49.32 years (range: 21–75 years). The majority of cases were AO type 43A3 (36%). Complete fracture union was achieved by 21 weeks (14–30 weeks). At final follow up 18 fractures united with no angulation at fracture site while 1 united in valgus (<10⁰) and 1 varus (<5⁰) and 3 in sagittal angulation (<10° angulation in both) which were consistent with acceptable limits. The mean AOFAS score was 79.16 after 8 months, with 4 cases having excellent outcome, 14 good, 3 acceptable and 4 cases with bad outcome. The complications in this study were angular deformity 5(20%), Infection 4 (16%), non-union 2 (8%), implant breakage 1 (4%).

Anterolateral distal Tibial plating by MIPPO technique gives good functional and radiological outcome with advantage of minimal soft tissue dissection without stripping the periosteum and preventing subsequent devascularisation of fracture fragments but it requires a long learning curve. Thus we conclude that anterolateral distal Tibial locking plate is a good option for managing the distal Tibial fractures.