title: Minimally invasive percutaneous plate osteosynthesis does not increase complication rates in extra-articular distal tibial fractures.
abstract: BACKGROUND
  Selection of a treatment method in cases of unstable, nonarticular distal tibial fractures is still a matter of discussion. Intramedullary nailing, which is a "gold standard" for tibial shaft fractures, does not always work for this specific transition area between diaphysis and metaphysis. Instead, new minimally invasive techniques with special implants are popular.
  
  
  OBJECTIVE
  To determine the functional and radiological results of distal tibial fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) technique.
  
  
  METHODS
  Retrospective cohort analysis.
  
  
  METHODS
  Thirty distal tibial fractures treated with MIPPO method, between January 2006 and December 2010, were evaluated retrospectively. All patients were classified according to AO/OTA classification. Period of hospital stay, time of fracture union, time to allow full weight bearing, early and late complications were inquired. Functional outcomes were assessed by AOFAS scores.
  
  
  RESULTS
  There were 13 male and 17 female patients with an average age of 44.26 (range, 22-77 years). One superficial infection and one malunion were observed. Two patients were revised for the loss of reduction and healed uneventfully. According to the AO/OTA classification, 23 patients were 43-A1 (76.6%), 3 were 43-A2 (10%) and 4 were 43-A3 (13.3%). Post-operative mean stay of patients at the hospital was 2.6 ± 1.42 days (range, 1-7 days). Mean full weight-bearing period of the patients was found out as 13.16 ± 2.6 weeks (range, 10-22 weeks). The mean period of union of fracture for patients was found out as 19.8 ± 2.99 weeks (range, 16-34 weeks).
  
  
  CONCLUSIONS
  Treatment of distal tibial fractures with MIPPO method provides a successful treatment strategy as long as used as per the technique, and it respects and does not harm soft tissues which allows early callus formation and rapid healing that enable the patient to walk as early as possible after the operation. The overall clinical and functional outcome is still good despite minor complications.
authors: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Izzet
authors: I
authors: Bingol
authors: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Nadir
authors: N
authors: Yalcin
authors: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Vedat
authors: V
authors: Bicici
authors: Yenimahalle State Hospital, Ankara, Turkey.
authors: Tolga
authors: T
authors: Tulunay
authors: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Kaan
authors: K
authors: Yuksel
authors: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey.
authors: Kasim
authors: K
authors: Kilicarslan
keywords: Minimal invasive surgery; tibial fractures; treatment outcome