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.
Keywords:
biological fixation, minimally invasive surgery, proximal tibial fractures