Clinical observation on treatment of proximal metaphyseal fracture of tibia using minimally invasive percutaneous plate osteosynthesis / 中国矫形外科杂志

ABSTRACT

[Objective]To summarize the surgical management and clinic results of the minimally invasive percutaneous plate osteosynthesis(MIPPO) technique in treatment of proximal metaphyseal fractures of tibia.[Method]Twenty-five patients with proximal metaphyseal fracture of tibia underwent the MIPPO operation in our department.There were 18 males and 7 females,with a mean age of 42.6 years(ranged from 21 to 66 years).According to AO classification,17 cases were type 41-A,and 8 cases were type 41-C,of the 25 cases,8 were multiple injuries,4 of these were open fractures(2 cases of Gustilo-Anderson type Ⅱ and 2 cases of type ⅢA).According to creiteria of Johner-Wruch,excellent in 14 cases,good in 9 cases,fair in 2 cases,the excellent and good rate was 92%.[Result]The average intra-operative time was 90 minutes(ranged from 70 to 115 minutes).The average blood loss was 260 ml.No patient received blood transfusion.There were no superficial and deep infection occurred in this group.All patients were available for follow-up at an average of 1.8 years(ranged,1 to 2.5 years) after surgery.The mean time for bony union on X ray was 13.8(10～20)weeks,while the mean time for full weight bearing was 14.5(11～28) weeks.No malunion and failure of fixation were observed.[Conclusion]MIPPO is a safe and effective technique for the proximal metaphyseal fracture of tibia with the advantage of less invasion,steady fixation,low infection rate and higher union rate,which is accordant with biological fixation.