Outcome of minimally invasive percutaneous plate osteosynthesis (MIPPO) for closed comminuted fractures of upper metaphysis of Tibia

Background: Management of complex metaphyseal fractures is usually complicated by articular extension, characterized by the difficulty of achieving accurate joint reconstruction and the sufficient stabilization without jeopardizing the usually severely traumatized soft tissue envelope. Minimally invasive percutaneous plate osteosynthesis (MIPPO) method of fracture fixation proposes the advantages of indirect fracture reduction and percutaneous submuscular implant placement. Methods: 20 patients with AO/ASIF 41A-B-C fractures of proximal tibia were followed up from December 2016 to June 2018. All the patients underwent Minimally invasive percutaneous plate osteosynthesis (MIPPO) with medial proximal tibial LCP. Clinical and radiological follow-up were recorded for 18 months. Results: Mean surgical time in minutes was 59.2. The average time for appearance of callus was 4 to 5 weeks and full weight bearing duration 20 to 38 weeks. Average range of movements for flexion 121.7 degree and extension 1.8 degree. Conclusion: MIPPO plating of proximal tibial fractures permits stable fixation, mobilization and avoid soft tissue related complications.