Introduction: Unstable fractures of the distal tibia with or without intra-articular extension can present a clinical dilemma. Historically, there have been a variety of methods of management described but with high rates of associated complications. Minimally Invasive Plate Osteosynthesis (MIPO), has now become more in demand with the development of the Locking Compression Plates. MIPO offers many biological superiorities including minimal soft tissue dissection with preservation of vascular integrity of the fracture as well as preserving osteogenic fracture hematoma.

Materials and Methods: A total of 30 patients with distal tibia fractures (open/closed) were included in the study after informed consent. Patients were treated by MIPO and were prospectively followed up. Duration of follow-up ranged from 3-6 months. Demographic variables, mode of injury, time required for union, complications and clinical improvement were recorded and analyzed.

Results: Most of the fractures were united by 4 months (83.3%) with a mean union time of 4.26± 0.98 months. Excellent clinical results with MIPO were observed in 66.7 % of cases while poor results were obtained in 6.7% of cases. Complications were seen in 15 subjects (50%), of which most common was wound infection, seen in 66.6% of the cases.

Conclusion: MIPO is an effective technique in the management of distal tibial fractures. It is minimally invasive, though technically demanding, but saves the biological environment by preserving the soft tissue with better outcomes in terms of radiological union and clinical improvement.

Keywords: Distal tibial fractures, MIPO, intramedullary nailing.

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Dr Kiran Gurung

Orthopedic Surgeon

Western Hospital Pvt. Ltd., Nepalgunj, Nepal