Comparison between plating by MIPPO and IMLN in proximal tibia extra-articular fractures: Our experience at a tertiary care hospital

Abstract

To assess the effectiveness of the two techniques (MIPPO & IMILN) & Compare outcome. Methods: This is a Prospective, Randomized control trial involving 52 cases of extra-articular proximal tibial fractures treated either with MIPPO or IMILN in the Department of Orthopaedics, IMS and SUM Hospital, Bhubaneswar during September 2017 to September 2019. Functional outcome was calculated with Lower extremity functional scale and Knee society score and final outcome with Johner Wruhs criteria.Results: Each group had 26 cases in them, cases were followed-up for an average duration of 11.9 months. 2 cases from MIPPO group and 4 from IMILN group lost follow up. The average time to radiological union in MIPPO group was 16.1 weeks and that in IMILN group was 16.9 weeks. IMILN group had a higher rate of mal-reduction (19.1%) than MIPPO (15.4%). anterior angulation of the proximal fragment was commonest. Superficial infection occurred in 8.3% cases of MIPPO group and 4.5% in IMILN group. Non-union occurred in 1 (4.2%) and 1 delayed union (4.2%) in MIPPO group. Non-union developed in 1 case in IMILN group (4.5%) and 2 cases of delayed union (9.1%). Implant irritation was seen in 2 of our cases (8.3%) in MIPPO group. Anterior knee pain was observed in 2 patients in IMILN group (9.1%). LEFS in MIPPO was 45.8% and IMILN was 40.9%. Final outcome showed excellent result in 50% and 45.4% in MIPPO and IMILN respectively. Conclusions: If principles of treatment are correctly followed, most of cases will have excellent result with either modality of treatment.