title: Minimally invasive plate osteosynthesis using posterolateral approach for distal tibial and tibial shaft fractures.
abstract: OBJECTIVE
  The objective of the study was to evaluate the effectiveness of the posterolateral minimally invasive plate osteosynthesis (MIPO) method for managing distal tibial or tibial shaft fractures with severe anterior and medial soft tissue injuries.
  
  
  METHODS
  Five consecutive patients with three distal tibial and two tibial shaft fractures (three open fractures) at a level-1 trauma and tertiary referral center were retrospectively reviewed. All patients were definitively treated and followed to bone union. Main outcome was measured by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, complications, and bone union on radiographs.
  
  
  RESULTS
  The average follow-up period was 15.8 months (range, 12-24 months). The average AOFAS score was 88.2 (range, 81-90). There were no complications, such as incision breakdown, deep infection, or impingement of the flexor hallucis longus tendon. Bone union was achieved in all cases.
  
  
  CONCLUSIONS
  Posterolateral MIPO is a feasible option when treating these fractures, especially in cases with severe anterior and medial soft tissue injuries.
authors.affiliation: Fukuyama City Hospital Emergency Medical Center, Division of Orthopaedic Trauma, Hiroshima, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Fukuyama City Hospital Emergency Medical Center, Division of Orthopaedic Trauma, Hiroshima, Japan. Electronic address: rxf04257@nifty.com.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ogawa
authors.affiliation: Fukuyama City Hospital Emergency Medical Center, Division of Orthopaedic Trauma, Hiroshima, Japan.
authors.forename: Chuji
authors.initials: C
authors.lastname: Terada
authors.affiliation: Fukuyama City Hospital Emergency Medical Center, Division of Orthopaedic Trauma, Hiroshima, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Okazaki
authors.affiliation: Fukuyama City Hospital Emergency Medical Center, Division of Orthopaedic Trauma, Hiroshima, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Munetomo
authors.affiliation: Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Orthopaedic Surgery, Okayama, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Noda
authors.affiliation: Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Department of Orthopaedic Surgery, Okayama, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014193:Trauma Centers; D016896:Treatment Outcome; D016474:Weight-Bearing; D055815:Young Adult
keywords: Distal tibial fracture; Minimally invasive plate osteosynthesis; Posterolateral approach; Staged treatment; Tibial shaft fracture