Effectiveness of Minimally Invasive Plate Osteosynthesis (MIPO) on Comminuted Tibial or Femoral Fractures

Abstract

Background: Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site,<br />known as minimally invasive plate osteosynthesis (MIPO), has recently become prevalent. This study has been<br />designed to assess the outcomes of this treatment for tibial and femoral comminuted fractures.<br />Methods: A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in this<br />cross-sectional study at Alzahra university hospital in 2015. Eleven patients were excluded due to lack of adequate<br />follow-ups. Patients'data including union time; infection in the fractured site; hip and knee range of motion; and any<br />malunion or deformities like limb length discrepancy were collected after the surgery in every session.<br />Results: Among 32 femoral and 17 tibial fractures, union was completed in48 patients, while only one patient with<br />femoral fracture had nonunion. The mean union time was 18.57±2.42 weeks. Femur fractures healed faster than tibia<br />(17.76±2.36 compared to 19±2.37 weeks, respectively, P=0.09). None of the patients suffered from infections or fistula.<br />The range of motion in hip and knee remained intact in approximately all patients. Malunion happened in 3 patients; 100<br />internal rotation in 1 patient; and 1cm limb shortening in 2 patients.<br />Conclusion: According to the result of this study, MIPO is a simple and effective method of fixation with a high rate<br />of union as well as minimal complications for comminuted fractures of long bones. Infection is rare, and malunion or<br />any deformity is infrequent. MIPO appears to be a promising and safe treatment alternative for comminuted fractures.