title: Minimally invasive plate osteosynthesis for distal tibial fractures.
abstract: OBJECTIVE
  To review the outcomes of 53 patients who underwent minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures.
  
  
  METHODS
  Medical records of 31 men and 22 women aged 22 to 78 (mean, 51) years who underwent MIPO using a locking compression plate for distal tibial fractures of the left (n=28) and right (n=25) legs with or without intra-articular extension were reviewed.
  
  
  RESULTS
  Patients were followed up for a mean of 26 (range, 24-38) months. The mean time from injury to surgery was 9 (range, 3-12) days. The mean operating time was 105 (range, 75-180) minutes. The mean hospital stay was 16 (range, 8-25) days. Non-weight bearing walking with a crutch was started after a mean of 5.7 (range, 3-9) days. The mean time to callus formation was 12 (range, 8-15) weeks. The mean time to full weight bearing was 15 (range, 8-22) weeks. The mean time to bone union was 25 (range, 20-30) weeks. All except 2 fractures united anatomically. At 10 months, the range of motion of the ankle joint in all patients was similar to the contralateral side. Two patients had malunion but this was not clinically significant. Five patients had superficial infection, and 2 patients had persistent pain.
  
  
  CONCLUSIONS
  MIPO is effective for closed, unstable fractures of the distal tibia. It reduces surgical trauma and preserves fracture haematoma.
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Gandaki Medical College Teaching Hospital, Pokhara, Nepal.
authors.forename: Pramod
authors.initials: P
authors.lastname: Devkota
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Patan Hospital, Lalitpur, Nepal.
authors.forename: Javed A
authors.initials: JA
authors.lastname: Khan
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Patan Hospital, Lalitpur, Nepal.
authors.forename: Suman K
authors.initials: SK
authors.lastname: Shrestha
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Patan Hospital, Lalitpur, Nepal.
authors.forename: Balakrishnan M
authors.initials: BM
authors.lastname: Acharya
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Patan Hospital, Lalitpur, Nepal.
authors.forename: Nabeesman S
authors.initials: NS
authors.lastname: Pradhan
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Patan Hospital, Lalitpur, Nepal.
authors.forename: Laxmi P
authors.initials: LP
authors.lastname: Mainali
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Kaski Sewa Hospital, Pokhara, Nepal.
authors.forename: Padam B
authors.initials: PB
authors.lastname: Khadka
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Kaski Sewa Hospital, Pokhara, Nepal.
authors.forename: Hemanta K
authors.initials: HK
authors.lastname: Manandhar
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult
keywords: bone plates; fracture fixation, internal; tibial fractures