OUTCOME OF MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS WITH LOCKING COMPRESSION PLATE IN DISTAL TIBIA FRACTURES

Abstract

Background: Distal tibia fractures are challenging to manage due to limited soft tissue coverage, compromised blood supply, and a high risk of complications. Minimally invasive plate osteosynthesis (MIPO) with locking compression plate has been introduced to provide stable fixation while preserving fracture biology. Objective: To determine the outcome of minimally invasive plate osteosynthesis with locking compression plate in distal tibia fractures in terms of fracture union. Methodology: This was a descriptive case series conducted at the Department of Orthopedic Surgery, King Edward Medical University (KEMU) and its affiliated hospitals, Lahore, from February 2025 to June 2025. A total of 105 patients diagnosed with distal tibia fractures were enrolled using a non-probability consecutive sampling technique. All included patients underwent minimally invasive plate osteosynthesis (MIPO) with a locking compression plate as the definitive surgical treatment.

Results: Fracture union was achieved in 82 patients (78.1%). Patients who achieved union were younger (37.1 ± 10.6 years) compared to those who did not (45.2 ± 12.0 years, p = 0.008), had lower body mass index (26.0 ± 3.1 kg/m² vs. 28.3 ± 3.5 kg/m², p = 0.01), and presented earlier (2.5 ± 0.9 weeks vs. 3.8 ± 1.4 weeks, p < 0.001). Mean RUST score (10.4 ± 1.0 vs. 6.9 ± 1.3) and mean AOFAS score (85.2 ± 8.5 vs. 57.1 ± 10.6) were significantly higher in the union group (p < 0.001).

Conclusion: Minimally invasive plate osteosynthesis with locking compression plate yields satisfactory radiological and functional outcomes in distal tibia fractures. Patient-related factors, fracture complexity, and postoperative complications significantly influence fracture healing and overall outcome.