Minimally Invasive Percutaneous Plate Osteosynthesis (Mippo) In The Treatment Of Pilon Fractures: A Prospective Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 11
Abstract
Background: The management of Pilon fractures is challenging because of its poor vascularity, scarcity of soft tissues and it’s subcutaneous nature. A mechanically stable fracture-bridging osteo-synthesis can be obtained without significant dissection and surgical trauma to the bone and surrounding soft tissues by minimally invasive percutaneous plate osteosynthesis (MIPPO). Aim: The following study is to evaluate the functional outcome of Tibial Pilon fractures treated with minimally invasive per cutaneous plate osteo synthesis(MIPPO) using locking compression plate Methodology: the study was conducted in patients with Pilon fractures treated with MIPPO with LCP Who are admitted in department of orthopaedics in Maharaja’s institute of medical sciences , Vizayanagaram from January 2016 to June 2017 . 30 patients were prospectively underwent mippo for Pilon fractures. patients were ranged from 24-67 years with average age of 42 years .out of these 21 (70%) patients are males and 9(30%) are females. postoperative regimen includes Non-weight bearing of the patient using standard walking from the first postoperative day under the supervision of a physiotherapist. patient was allowed to weight bearing on 4th week post operatively, the patients were followed up at intervals of four weeks for up to 6-10 months to assess the radiological union and functional outcome. Functional evaluation of results was done by OLEURD and MOLANDER scoring system. Radiological evaluation is done by serial x-rays at each follow up. Observation and Results:21 (70%) of patients sustained injury following road traffic Accidents (high velocity) and 9 (30%) patients sustained injury following fall (low velocity). 18 (60%) patients with right pilon fractures and 12(40%) patients with leftfractures. 30 cases treated with MIPPO with locking compression plates 1 (3.33%) case took 31-40 minutes, 8 (30%) took 41-50 minutes,15(50%) took 51-60 minutes,4(13.33%) took 61- 70 minutes, 1(3.33%) took 71-80 minutes. The surgical time averaged 55.83 minutes. All the fractures united with an average of 20 weeks. There was 10 cases united by 16 weeks, 17 cases united by 20 weeks and 3 cases united by 24 weeks. Conclusion: The greatest advantage of MIPPO technique with locking compression plate is to preserve the blood supply and fracture haematoma is not disturbed much, which helps in fracture healing .By the analysis of the data collected in the present study, closed reduction and internal fixation with locking compression plate using MIPPO technique for pilon fractures is the choice of treatment where intramedullary nails are not preferred and complication rates as compared to open reduction and plating and intra medullary nailing is significantly lower. Although, a larger sample of patients and longer follow up are required to fully evaluate this method of treatment, we strongly encourage its consideration in the treatment of pilon fractures in an endeavour to reduce morbidity and associatedcomplications , especially of the soft tissue.
Authors and Affiliations
Arjun K Unnam, Shruthikanth S, Venkateswararao M
Keywords
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- EP ID EP416526
- DOI 10.9790/0853-1711101523.
- Views 64
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