PURPOSE To evaluate the efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a lateral plate (Zimmer, Periarticular Lateral Distal Tibial Plates, USA) in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage. MATERIALS AND METHODS From January 2005 to December 2007, 15 patients with distal tibial fracture treated by MIPPO technique using a lateral plate were analyzed. The duration of follow-up was more than 1 year. We evaluated union time by simple X-ray, clinical results by IOWA ankle rating system, and complication. RESULTS The bone union was achieved in all cases at average 16.7 weeks. Evaluation of the ankle function test showed an average of 90.3 points, resulting in satisfactory. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. CONCLUSION We concluded that MIPPO technique using a lateral plate is a efficient method for high functional recovery with good bone healing and low complication in distal tibial fracture within 3 cm to plafond, associated with medial soft tissue damage.
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Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures Young-Mo Kim, Chan Kang, Deuk-Soo Hwang, Yong-Bum Joo, Woo-Yong Lee, Jung-Mo Hwang Journal of the Korean Fracture Society.2011; 24(3): 230. CrossRef
Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef
PURPOSE To evaluate the outcomes of distal tibial open fractures treated by two-staged delayed minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. MATERIALS AND METHODS 25 cases of distal tibial open fractures were treated with temporary ring fixation and two-staged delayed MIPPO. A mean age was 46 years old, follow-up was 23 months. The type of fracture was evaluated using the AO/OTA classification. The type of open fracture was evaluated using the Gustilo-Anderson classification that revealed 6 cases of type I, 9 cases of type II, 8 cases of type IIIA and 2 cases of type IIIB. We analyzed the radiologic results and postoperative complications. The clinical and functional result were evaluated by using Teeny and Wiss scores. RESULTS The average time of bone union was 18 weeks in 24 cases. There were three delayed union that achieved union twenty weeks after second operation, and 1 case underwent bone graft with additional plate fixation. 6 cases of skin necrosis were treated with skin graft, 2 cases were treated with flap. The clinical and functional assessment showed that 6 cases were excellent, 16 cases were good, 2 cases were fair, and 1 case were poor results. CONCLUSION Two-staged MIPPO technique for distal tibia open fractures seems to be a good procedure to obtain bone union.
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Combined minimally invasive external and internal fixation in the treatment of pilon fractures AhmedSh Rizk, MohamadS Singer, MohamadE Al-Ashhab The Egyptian Orthopaedic Journal.2014; 49(3): 259. CrossRef
Staged Protocol in Treatment of Open Distal Tibia Fracture: Using Lateral MIPO Oog Jin Sohn, Dong Hwa Kang Clinics in Orthopedic Surgery.2011; 3(1): 69. CrossRef
Management of Open Fracture Gu-Hee Jung Journal of the Korean Fracture Society.2010; 23(2): 236. CrossRef
Staged Minimally Invasive Plate Osteosynthesis of Distal Tibial Fractures Sung-Ki Park, Chang-Wug Oh, Jong-Keon Oh, Kyung-Hoon Kim, Woo-Kie Min, Byung-Chul Park, Won-Ju Jeong, Joo-Chul Ihn Journal of the Korean Fracture Society.2010; 23(3): 289. CrossRef
PURPOSE To evaluate the clinical results of minimally invasive percutaneous plate osteosynthesis using a periarticular plate (Zimmer, Warsaw, IN, USA) for distal tibia fractures. MATERIALS AND METHODS 27 patients with distal tibia fractures were treated operatively by minimally invasive percutaneous plate osteosynthesis. The patients were followed for at least 1 year. The duration for bone union, complications after the surgery, the amount of skin irritation at the site of plate insertion was evaluated using the VAS score and the Olerud and Molander ankle score. The average age of the patients was 56 years old (range, 30~81 years) with an average follow up period of 21 months (range, 12~30 months). RESULTS The average time from trauma to surgery was 6 days (range, 2~19 days). 10 cases showed an associated distal fibular fracture. The average time for bone fusion was 14 weeks (range, 8~40 weeks) with 1 case of angular deformity with more than 5 degrees. The amount of skin irritation due to the periarticular plate resulted in a VAS score of 2.2 points. Evaluation of the ankle function test showed an average of 90.2 points, resulting in satisfactory. CONCLUSION The periarticular plate used in minimally invasive percutaneous plate osteosynthesis for distal tibia fractures was concluded to give a firm fixation of the fracture site as bony fusion could be acquired without any callus formation, and few skin irritation due to plate has seem to be an advantage.
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Minimally Invasive Osteosynthesis with Locking Compression Plate for Distal Tibia Fractures Sung-Kyu Kim, Keun-Bae Lee, Keun-Young Lim, Eun-Sun Moon Journal of the Korean Fracture Society.2011; 24(1): 33. CrossRef
Anatomically Percutaneous Wiring Reduction in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fractures Young-Mo Kim, Chan Kang, Deuk-Soo Hwang, Yong-Bum Joo, Woo-Yong Lee, Jung-Mo Hwang Journal of the Korean Fracture Society.2011; 24(3): 230. CrossRef
Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture Oog Jin Shon, Dae Sung Kim Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef
PURPOSE To evaluate the efficacy of the surgical treatment through the comparison of MIPPO vs open plate fixation in the treatment of the distal tibia fracture retrospectively. MATERIALS AND METHODS 30 patients with distal tibia fracture from Jun. 2001 to Jun. 2004 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 15 patients treated with MIPPO, Group B was 15 patients treated with open plate fixation. The clinical outcomes were evaluated retrospectively from operation time, rehabilitation, ROM, interval change of postoperative CRP to assess postoperative inflammatory reaction, postoperative complications and clinical result with the use of McLennan and Ungersma criteria. RESULTS There were no significant differences in clinical result by McLennan and Ungersma criteria in both groups. The postoperative 3 days and 7 days CRP were 4.0mg% (0.9~7.2)/0.5 mg% (0.1~1.5) in group A and 7.97mg% (2.8~14.6)/1.0mg% (0.3~1.6) in group B, shows more minimal tissue injury and early recovery in group A. Operation time in group A was shorter than group B. Normal recovery of ROM was quicker in Group A. In complications, group A showed one superficial infection and one angular deformity and group B showed one superficial infection, one infected nonunion and two ankle stiffness. CONCLUSION There were no significant differences in clinical result and bony union. MIPPO technique is superior to group B in view of the minimal tissue injury, complications, operation time and postoperative rehabilitation.
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Minimally Invasive Percutaneous Plate Osteosynthesis Using a Lateral Plate in Distal Tibial Fracture Oog Jin Shon, Dae Sung Kim Journal of the Korean Fracture Society.2010; 23(1): 42. CrossRef