European Journal of Molecular & Clinical Medicine

Abstract

Introduction: The purpose of this study is to assess the outcome of plate fixation in proximal
tibia fracture through minimally invasive percutaneous osteosynthesis technique in tertiary
care centre.
Materials and Methodology: This study included, 38 men and 7 women aged 19 to 75
(mean, 40; standard deviation [SD], 14) years underwent Minimal Invasive Percutaneous
Osteosynthesis (MIPO) for the displaced tibia plateau fractures. Fracture was classified
according to Schatzker system. Patient was assessed on the basis of the Rasmussen anatomic
score and the Rasmussen functional score. Patients with acceptable and unacceptable
outcomes were compared in terms of age using the Chi squared test or Fisher’s exact test.
Results: The mean Rasmussen anatomic score was 15.1 (SD, 2.2; range, 10–18); the mean
Rasmussen functional score was 25.3 (SD, 3.2; range, 14–29); and the mean range of knee
motion was 118º (SD, 10º; range, 90º–140º) [Tables 1]. 27 (68%) of the 40 patients with
acceptable anatomic outcome were aged ≤45 years, whereas 3 (60%) of the 5 patients with
unacceptable anatomic outcome were aged ≥60 years (p=0.001). Functional outcome was
excellent in 19, good in 20, and unacceptable in 6 patients (2 had Schatzker type-I&III and
another 2 had each Schatzker type -II&IV fractures). 39 of the patients had a range of knee
motion of ≥120º; 28 (72%) of them were aged ≤45 years, whereas 4 (67%) of the 6 patients
with unacceptable functional outcome were aged ≥60 years (p=0.001).
Conclusion: MIPO with locking plates can provide effective satisfactory results in proximal
tibial fracture. Tibia is a subcutaneous bone in most of its part, MIPO technique leads to less
soft tissue damage and less incidence of post operative wound dehiscence, which is a great
hurdle for the surgeons. Sufficient numbers of screws in plates in metaphyseal fracture or
selection of a long plate for diaphyseal fracture might be a helpful choice to achieve stable
fixation of the fracture.