title: [Close reduction by Chinese traditional manipulation and MIPPO for the treatment of tibial fractures in middle and distal segment].
abstract: OBJECTIVE
  To explore the technique and clinical results of close manipulative reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of tibial fractures in the middle and distal segment.
  
  
  METHODS
  From Jan. 2005 to Dec. 2009, 40 patients with tibial fractures in middle and distal segment were treated with close manipulative reduction and MIPPO fixation, including 28 males and 12 females with an average age of 54 years old (ranging from 21 to 76). According to AO fractures classification for the tibial fractures in the middle and distal segment, there were 26 cases of type A, 8 of type B, 6 of type C.
  
  
  RESULTS
  All patients were followed up for 12 to 24 months (averaged 18 months). All the fractures gained bone healing, and the time required for the bony union ranged from 3 to 18 months (averaged 4 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the ankle. The aggregate score was 96.67 +/- 3.91, involving pain 48.59 +/- 2.28, hills up 2.95 +/- 0.22, hills down 2.85 +/- 0.37, stairs down 2.92 +/- 0.35, run score 4.95 +/- 0.32, plantar flexion score 4.62 +/- 0.54, dorsiflexion score 4.13 +/- 0.61. The clinical results were excellent in 36 cases, good in 3 and fair in 1.
  
  
  CONCLUSIONS
  Close manipulative reduction and MIPPO fixation is a good method for the treatment of the tibial fractures in the middle and distal segment.
authors.affiliation: Sichuan Province Orthopedic Hospital, Chengdu 610041, Sichuan, China. liuxiandong@163.com
authors.forename: Xian-Dong
authors.initials: XD
authors.lastname: Liu
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Wang
authors.forename: Zong-De
authors.initials: ZD
authors.lastname: Wu
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.forename: Jin-Wen
authors.initials: JW
authors.lastname: Zheng
authors.forename: Xing-Yu
authors.initials: XY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012867:Skin; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D055815:Young Adult