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Minimally Invasive Percutaneous Plate Osteosyntesis Technique for Pilon Fractures of Distal Tibia

Ahmad Kamal  
【摘要】: Objective: Minimally Invasive Percutaneous plate Osteosynthesis, has been introduced to utilise all of the recent developments in biological osteosynthesis and internal fixators. It involves inserting a plate percutaneously, bridging the fracture site which is secured proximal and distal to the fracture zone. It also offers biological advantages and involves minimal soft tissue dissection with preservation of the vascular integrity of the fracture as well as preserving osteogenic fracture haematoma. This study aimed to evaluate the biological advantages of MIPPO in treating the pilon fractures of distal tibia. Methods: We conducted a study on indirect reduction and minimally invasive percutaneous plating in the treatment of 26 cases of pilon fractures of distal tibia, some with extension to ankle with minimal displacement, using locking dynamic compression plate. All fractures were classified according to AO classification.18 fractures were peri-articular and 8 were intra-articular. All were closed fractures. Results: At final follow up 10.7 months (mean, 6-20 months), all the fractures were healed without repeating the surgery and the mean union time was 14.9 weeks. One patient had mal-alignment of the limb with 8? internal rotation, but there were no angular deformity more than 5?. One patient had impingement of hardware but was removed after healing of fracture. All patients had excellent or satisfactory ankle function. There were no infections or serious soft tissue complications. Conclusion: MIPPO technique results in higher rates of union and minimizes the complication rates in the pilon fractures of distal tibia.


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