A retrospective evaluation of the results of the application of MIPPO technique with osteosynthesis on 26 cases of tibial fracture
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Aim. This retrospective study aimed to evaluate the use of minimally invasive percutaneous plate osteosynthesis (MIPPO) technique on 26 cases of tibial fractures, which are frequently encountered in orthopedic traumatology. Methods. The study comprised 26 patients with tibial fractures who had been operated on with the MIPPO technique at our clinic between June 2006 and December 2008. Sixteen patients were male and 10 female with a mean age of 36.3 years (range 24-57 yrs). Three of the cases were determined as Grade I open fracture. A low profile 3.5 mm limited contact dynamic compression plate (LCDCP) was used on all cases. On postoperative day 2 all patients were allowed full movement but they were discharged without weight-bearing. Some of the patients commenced weight-bearing in the 6th week in accordance with follow-up radiographs. No patient was allowed full weight-bearing before the fourth month. Results. All the cases achieved clinical and radiological union. At the final follow-up all the cases were seen to be able to continue their lives with unrestricted daily activity. None of the cases developed superficial or deep tissue infection. Within one week postoperative three cases displayed minimal clinical findings of having developed deep vein thrombosis. This was eradicated within 15 days by medical treatment. The mean time to full weight-bearing was 5.6 months. Extirpation was necessary in 11 cases because of skin irritation due to the plate. Conclusion. According to our opinion MIPPO technique for diaphyseal and distal fractures of the tibia is simple to apply, engenders better rehabilitation and has few complications. We believe that MIPPO technique with low profile and LCDCP plate can be applied to selected patients.