[Application of minimally invasive locking compression plate in treatment of distal tibia fractures]

To evaluate the application of minimally invasive plate osteosynthesis (MIPO) technique in treatment of distal tibia fractures with locking compression plate (LCP).

From August 2002 to August 2007, 62 subjects were recruited (36 males and 26 females) at mean age of 44 years old (range, 21-87 years old). According to AO classification, there were 8 cases of type A1, 15 cases of type A2, 9 cases of type A3, 7 cases of type B3, 11 cases of type C1, and 12 cases of type C2. Of them, 52 patients had closed fractures and 10 had open fractures. Ten open fractures included 6 Grade I fracture and 4 Grade II fracture. The time from injury to operation was 8 hours to 6 days. The X-ray films were taken after 3 months of operation.

Near anatomical reduction was achieved in 56 fractures and acceptable reduction in 6 fractures. Mean operation time was 43 minutes (range, 37-120 minutes). Primary healing of surgical wounds was observed in all cases. Subjects were followed up for 23 months on average (ranged, 18-45 months). All fractures healed with a mean healing time of 19.5 weeks (range, 16-32 weeks). According to Teens and Wiss ankle scoring system, 30 patients got excellent results, 25 good, and 7 fair; and the excellent and good rate was 88.7% at 12-month follow-up. There were 7 cases of delayed soft tissue infection which needed implant removal. There was one complication of compartment syndrome which required fasciotomy. There was one case with loss of reduction (valgus tilting of tibial plafond) that required bone grafting.

The results of MIPO LCP in treatment of distal tibia fractures were satisfactory. This technique was safe with no incidence of serious complications.