Functional outcome of extra-articular distal tibia fractures treated with minimally invasive plate osteosynthesis

OBJECTIVES: The purpose of this research is to study whether minimally invasive plate osteosynthesis leads to consistent union and early return to work. The specific objectives included: 1. Correlation between the functional scores and radiological parameters of distal thirds diaphyseo - metaphyseal tibial fractures treated by minimally invasive plate osteosynthesis along with the time to bony union and 2. Documentation of the major and minor complications associated with this treatment modality. METHODS: A retrospective study was performed on patients who underwent minimally invasive plate osteosynthesis of their distal tibia fracture in Department of Orthopaedics Unit 3 from January 2008 to December 2011. Demographic data such as mechanism of injury, level and pattern of the tibia and fibula fracture, associated injuries, duration between injury and treatment and length of follow-up were recorded from the hospital records. The patients were then requested to come to the hospital for a routine visit. Consent was obtained from the respective patients and a detailed clinical assessment was done by the two examiners independently followed by specific functional scores and measurement of radiograph parameters. The functional outcome was measured by using standard questionnaires and consisted of the AOFAS (American Orthopaedic Foot and Ankle Society score & Olerud and Molander scores and were then graded as excellent/ good/ fair and poor and compared to similar studies by other authors. Radiographic assessment was done comparing the anteroposterior and lateral views of the affected and the normal leg with both the knee and ankle joint included and the time to union, malunion and shortening were documented. All major and minor complications were documented at follow up. RESULTS: 22 patients (84.7%) had uneventful healing of the fractures. Delayed union and infection occurred in two patients each (7.5%). All fractures healed without the need of any secondary procedures. There was no noticeable mal- alignment or non-union. Functional outcome was good to excellent in all patients. Average time to bony union was 24 weeks. CONCLUSIONS: MIPO allowed uneventful healing and restoration of the pre-injury level of function in most patients