Treatment of Distal Tibial Metaphyseal Fracture Using MIPPO Technique

MIPPO 수기를 이용한 원위 경골 골간단 골절의 치료

  • Lee, Ho-Seung (Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Kim, Jung-Jae (Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Oh, Se-Kwan (Department of Orthopedic Surgery, Asan Medical Center, College of Medicine, Ulsan University) ;
  • Ahn, Hyung-Sun (Department of Orthopedic Surgery, Kang Neung Asan Hospital, College of Medicine, Ulsan University)
  • 이호승 (울산대학교 의과대학 서울아산병원, 정형외과학교실) ;
  • 김정재 (울산대학교 의과대학 서울아산병원, 정형외과학교실) ;
  • 오세관 (울산대학교 의과대학 서울아산병원, 정형외과학교실) ;
  • 안형선 (울산대학교 의과대학 강릉아산병원, 정형외과학교실)
  • Published : 2004.12.01

Abstract

Purpose: To evaluate the results of MIPPO (minimal invasive percutaneous plate osteosynthesis) technique for distal tibial metaphyseal fractures. Materials and Methods: It is a retrospective study of 13 patients who were treated by MIPPO technique for distal tibial metaphyseal fractures from Jan. 2001 to Jan. 2003. The average age was 46.7 years and mean follow-up period was 13.3 months. According to AO classification, there were 8 cases of A1, 3 cases of A2, 1 case of B1 and 1 case of C2. One case of A1 was a Gustilo-Anderson type I open fracture and fibular fractures were combined in 12 cases. We applied anatomical reduction and internal fixation for the fibular fractures and internal fixation on the medial side of the tibia by MIPPO technique for distal tibial metaphyseal fractures. Clinical results were evaluated using radiographic results, Neer score, the starting time of postoperative exercise and clinical complications. Results: According to the Neer score, all cases showed satisfactory results. Active ankle ROM was started at average 2.4 weeks ($2{\sim}4$ weeks) and full weight bearing ambulation at average 5.2 weeks ($4{\sim}8$ weeks) postoperatively. Union of fractures was obtained by average 14.4 weeks ($8{\sim}18$ weeks) postoperatively. Two cases showed $5^{\circ}$ limitation of motion without functional deficits and other cases showed satisfactory ROM results. One case had $6^{\circ}$ valgus deformity without functional deficits. There were not any other complications like soft tissue problems and delayed-or non-union. Conclusion: MIPPO technique for the treatment of distal tibial metaphyseal fractures is a feasible technique with a good clinical outcomes.

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