Percutaneous plate fixation of fractures of the distal tibia

Minimally invasive plate osteosynthesis (MIPO) of the distal tibia offers several theoretical advantages compared to classic open reduction and internal fixation. A mechanically stable fracture-bridging osteosynthesis can be obtained without significant dissection and surgical trauma to the bone and surrounding soft tissues. In this retrospective study we looked at the results and complications in ten consecutive patients treated with percutaneous plating for fractures of the distal tibia and plafond with a minimum follow-up period of one year. No significant soft tissue problems occurred. The need for bone grafting should be carefully evaluated in every case as we encountered two delayed unions. All fractures healed within one year; there was no fracture malunion. The use of indirect reduction techniques and small incisions to insert hardware is technically more demanding and requires strict radioscopic control throughout the procedure, but it considerably decreases surgical trauma to the soft tissues.