Mohammad Badsha Miah1, Mirza Osman Beg2, Md. Monowar Tarik3, Mohammad Abdul Hannan4, Mohammad Akram Alai5
1. Assistant Professor, Department of Orthopaedic Surgery, Sheikh Sayera Khatun Medical College Gopalgonj.
2. Associate Professor, Department of Orthopaedic Surgery, North East Medical College, Sylhet
3. Assistant Professor, Department of Orthopaedic Surgery, Rajshahi Medical College, Rajshahi,
4. Junior Consultant, Department of Orthopaedic Surgery, Gowainghat Health Complex, Sylhet.
5. Medical Officer, 100 Beded Sadar Hospital, Shariatpur.
Abstract
Although a distal tibia fracture necessitates surgical treatment, it is difficult to manage. Because the distal tibia is subcutaneous bone with poor vascularity, conventional osteosynthesis is ineffective. Minimally invasive plate osteosynthesis (MIPO) with locking compression plate (LCP) has emerged as an alternative therapeutic option because it respects the biology of the distal tibia and fracture hematoma while also providing a biomechanically robust design. This prospective study was conducted in the Department of Orthopedics Surgery, 100 Bedded Sadar Hospital, Shariatpur from 2016 to 2020 over a period of 4 years. A total of 20 patients with closed fracture of distal tibia were enrolled in this study. They were treated with LCP using MIPO technique. The functional outcome was evaluated with American Orthopaedic Foot and Ankle Society Score. The patients’ average age was 45.4 ±13.8 years, with a range of 21 to 68 years. Males were more prevalent than females. The male-to-female ratio was 3:2. The majority of patients (35.0%) were service holders, followed by business (30.0%), laborer (25.0%), and housewife (10.0%). RTA was the leading cause of injury (55.0%), followed by slip down the stairs (25.0%) and fall from height (20.0%). One (5.0%) patient experienced delayed union, two (10.0%) patient’s experienced superficial infection, and one (5.0%) patient experienced wound dehiscence. The mean union time was 16.45±4.63 weeks, ranging from 11 to 32 weeks, and the mean full weight bearing time was 14.50 5.03 weeks, ranging from 12 to 33 weeks. The outcome was excellent in 15 (75.0%) cases, good in 4 (20.0%) cases, and fair in 1 (5.0%) case. By offering adequate fracture healing, allowing rapid functional recovery, and avoiding severe cutaneous problems, minimally invasive plate osteosynthesis employing LCP proves to be a safer approach in the management of distal tibia fractures.
Key Words: Minimally invasive plate osteosynthesis (MIPO), locking compression plate( LCP), distal tibia fracture.