MIPO IN DISTAL TIBIAL METAPHYSEAL FRACTURES A COMPARISON AMONG DCP, LCP AND PRE-CONTOURED DT-LCP

Objective: To compare the results with three types of plates in treatment of comminuted distal tibial metaphyseal fractures with minimally invasive plate osteosynthesis (MIPO). Study Design: Retrospective non randomized comparative study. Place and Duration of Study: Department of Orthopaedic Surgery, CMH Multan, Muzaffarabad and Rawalpindi from Mar 2007 to Oct 2012. Patients and Methods: Total 51 patients were managed by MIPO technique. A 4.5mm Narrow Dynamic Compression Plate (DCP) was used in 16 cases, 4.5mm Narrow Locking Compression Plate (LCP) in 12 and 3.5 mm pre-contoured distal tibial LCP (DT-LCP) in 23 cases. Assessment was done monthly until radiological union and quarterly thereafter. Results: There were 37 males, 14 females, mean age of 33 years: (Range 14-66 years). Primary union achieved in 14 of 16 cases (87.5%) with DCP and 2 (12.5%) went on secondary union after bone grafting. 10 of 12 cases (83.33%) with LCP went into primary and two into secondary union (16.66%). Primary union occurred in all case treated by DT-LCP. One case of superficial infection occurred in each group. Functional results were “excellent to good” in 14 (87.5%) in DCP group, 11 ((91%) in LCP and 22 ((95.6%) in DT- LCP group. Time to union and functional outcome in the three groups was insignificant (p>0.05). Conclusion: MIPO may be used successfully, with different plates, for distal tibial metaphysial fractures because of less disturbance to soft tissue and blood supply