Management of Distal Tibia Metadiaphyseal Fracture-Minimal Invasive Percutaneous Plate Osteosynthesis (MIPPO) by Medial LCP Versus Expert Tibia Nailing (ETN) : A Comparative Study

Dr. NAVEEN RATHOR, Dr. ANAMENDRA SHARMA, Dr.UMA SHANKAR MEENA, Dr. udaypal bishnoi, Dr. Jitendra Rathore


Introduction: distal tibia fracture is often more complex because its unique anatomical characteristic of subcutaneous
location with precarious blood supply and proximity to ankle joint.
Due to lack of defined criteria of management and literature, the study is conducted to compare the complications and functional outcome of
mippo and expert tibia nailing.
Material and Method : Adult patient with extraarticular distal tibia fracture admitted to trauma centre in R.N.T. Medical college,Udaipur
were taken for this study.this is prospective study from january 2014 to december 2016.
Treatment method divided into two group-
Group A (MIPPO by LCP)-25 patient
Group B(expert tibia nailing)-25 patient
Results :
-e mean time for fracture radiological union was 17.08 wks with MIPPO and 15.78 weeks with nailing.
-e average time for full weight bearing In MIPPO was 15.34 wks and 13.82 weeks in nailing.
-In MIPPO, 3 patients showed superficial skin infection, 1 patient shows deep infections, 2 patients had skin necrosis and 3 patients had ankle
-In expert tibia nailing , 1 patient had superficial skin infection, 2 patient complain of anterior knee pain.
-None of the patients in both the groups had non union or implant failure.
Conclusion: both intramedullary nailing and locking plating can be safely used to treat OTA type-43A distal metadiaphyseal tibia fractures.
Closed nailing has the advantage of:-
-shortened operating time
-early weight bearing and early union
-decreased wound problems
We recommend fibular fixation whenever intramedullary nailing or locking plate fixation is used in distal tibiofibular fractures.



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