title: Plate on plate technique of minimally invasive percutaneous plate osteosynthesis in distal tibial fractures, an easy and inexpensive method of fracture fixation.
abstract: BACKGROUND
  Plate on plate technique can lessen operative time and patient morbidity.
  
  
  OBJECTIVE
  This study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study.
  
  
  METHODS
  Twenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS).
  
  
  RESULTS
  All the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population.
  
  
  CONCLUSIONS
  MIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity.
authors.affiliation: Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India.
authors.forename: Nasir
authors.initials: N
authors.lastname: Muzaffar
authors.affiliation: Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India.
authors.forename: Rafiq
authors.initials: R
authors.lastname: Bhat
authors.affiliation: Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Yasin
keywords: Bone Fractures; Percutaneous; Plate on Plate; Tibia