Minimally invasive plate osteosynthesis in the treatment of multifragmentary fractures of the proximal tibia
- Resource Type
- Academic Journal
- Authors
- Ibrahim, Elsayed M. Mohamady; Elbegawy, Hossam; Elgazar, Amr
- Source
- Egyptian Orthopedic Journal. Jun 01, 2012 47(2):206-212
- Subject
- Language
- English
- ISSN
- 1110-1148
BACKGROUND: Proximal tibia fractures with metaphyseal comminution present a difficult treatment challenge. Minimally invasive plate fixation (osteosynthesis) (MIPO) has theoretical advantages for the treatment of these injuries. This report presents the clinical results of the MIPO system for the treatment of a series of patients with complex proximal tibia fractures. PATIENTS AND METHODS: Between March 2003 and February 2007, 28 consecutive patients with comminuted proximal tibia metaphyseal fractures with intra-articular extension were treated with MIPO in Benha Faculty of Medicine. The mean age of the patients was 37 years (range between 21 and 60 years). There were 22 closed fractures and six grade I open fractures (Gustilo Anderson classification). RESULTS: The average follow-up was 23 months (range 12–48). In 26 (92.8%) out of 28 patients, the fracture heeled after the index procedure and had satisfactory results. One patient had a fair result because of valgus malalignment and replating was performed. One patient had a poor result because of deep infection and loosening. Postoperative fracture alignment was satisfactory in 26 out of the 28 cases and was maintained in all patients at union. There was no deep venus thrombosis or compartment syndrome. CONCLUSION: The MIPO can be used safely to treat complex proximal tibia fractures without the need for additional medial stabilization. Surgeons attempting to use MIPO should familiarize themselves with the significant technical differences between these and traditional plating systems to ensure satisfactory results.