A case study of distal tibial fractures managed with locking compression plate using MIPO technique

Vanaj Kumar, P (2015) A case study of distal tibial fractures managed with locking compression plate using MIPO technique. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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INTRODUCTION : Increased incidence of Road Traffic Accidents claims most of human mortality and morbidity in the current age. Hence, it forms the major epidemic of Modern world. Of these, fractures of distal tibia have been difficult to treat. In this era of increasing life expectancy, there is a rise of elderly population which, increases the incidence of these fractures in osteoporotic bones, adding to the morbidity. Due to the proximity of these fractures to the ankle, regaining full ankle movement may be difficult. Soft-tissue damage, comminution and fracture extension into the ankle joint lead to unsatisfactory results in many cases regardless of the treatment modality. Better understanding of the injury patterns, availability of better implants, the concept of early surgical fixation and early postoperative mobilization of joint all have convincingly improved the functional outcome of the patient to a large extent. AIM: To discuss the management of fractures of distal tibia. • To evaluate the biomechanical and biological advantages of Locking compression plates. • To evaluate clinical, functional and radiological outcomes after minimally invasive plate osteosynthesis using distal tibial locking compression plates. MATERIALS AND METHODS : The period of surgery and follow up extends from September 2012 to September 2014. Inclusion Criteria : 1. Age >/= 20 years, 2. Closed, unstable fractures of distal tibia, 3. Grade I & II compound distal tibia fractures, 4. Fractures in which acceptable closed reduction can be achieved. Exclusion Criteria : 1. Grade III Open fractures, 2. Irreducible fracture deformity, 3. Compartment Syndrome / poor local skin conditions, 4. AO type C3 fractures (articular comminution). RESULTS : The overall results of our study are much in favour of Minimally Invasive Plate Osteosynthesis for distal tibia fractures. The post operative pain was minimal and the post operative ankle function was very good. Though we had marginal skin necrosis in 4 cases, they healed with regular dressings and none of the cases went for skin and soft tissue procedures. CONCLUSION: To summarize, The advantages of locking compression plate are i. provides a biomechanicaly stable construct, ii. does not endanger periosteal blood supply, iii. preserves the fracture heamatoma The advantages of Minimally Invasive Plating are i. fracture fixation without disturbing the soft tissue cover, ii. less chances of infection, iii. early mobilization of the adjacent joint. Thus minimally invasive plate osteosynthesis using LCP proves to be a safer technique in the management of distal tibial fractures without intra-articular comminution by providing good fracture healing, enabling rapid functional recovery, and avoiding major skin complications.

Item Type: Thesis (Masters)
Uncontrolled Keywords: distal tibial fractures ; management ; locking compression plate ; MIPO technique
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 26 Sep 2017 01:01
Last Modified: 26 Sep 2017 01:01
URI: http://repository-tnmgrmu.ac.in/id/eprint/3339

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