Results and complications of minimally invasive medial plate osteosynthesis for distal metaphyseal tibial fractures: A prospective case series from Vietnam. (October 2021)

• Record Type: Journal Article
• Authors: Van Nguyen, Luong; Nguyen, Gioi Nang; Nguyen, Binh Lam; Bui, Ha Manh
• Is Part Of: Annals of medicine and surgery. Volume 70(2021)
• Publication Date: 2021-10
• Subjects: Distal tibial fracture -- Locking plate -- MIPPO -- Vietnam; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.102886
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction and importance: The treatment of a fractures in tibial distal metaphyseal remained controversial. The purpose of this study was to assess the results and complications of minimally invasive medial plate osteosynthesis for distal metaphyseal tibial fractures. Material and method: From April 2014 to December 2019, 70 patients were enrolled in the study who were underwent MIPPO for metaphyseal tibial fractures using a medial distal tibial locking plate in our hospital. Wound healing, alignment, full weight bearing time, function, and complications were recorded. Results: All wounds primarily healed, just one fibular plating wound was deeply infected. All tibial fractures were solid union without secondary displacement. The average time back to walk without a crutch was 12, 5 weeks. The mean AOFAS score was 89 at a mean of 15 months follow-up. There were seven cases of late infection, 14 patients of skin impingement by implants and nine cases of broken screws, who were older than 65 years old. No case was varus, valgus or rotation >5°. Conclusion: Minimally invasive medial plate osteosynthesis for the distal metaphyseal tibial fracture is safe and effective. This technique decreases the incidence of complications and can help patients to resume their function early. The implant impingement, late wound infections and screw breakage were the quite common complications in old patients but these complications could be simply resolved and did not affect the overall rehabilitation and functions of the patient. Highlight: The treatment of an unstable fractures in metaphyseal distal regions of the tibia remains controversial. Minimally invasive medial plate osteosynthesis for the distal metaphyseal tibial fracture is safe and effective. Implant impingement, late wound infections, screw breakage were the quite common complications in old patients. Removal of the implant due to late wound infection was rarely required in an acute situation. We advised to use more suitable anatomy locking plate for Vietnamese patients, for preventing skin impingement.