Evaluation of Outcome of Surgical Management of Distal Tibial Fracture by MIPO/Open Procedure

Abstract

Introduction: Distal tibial fractures are common orthopedic injury. These fractures involve distal tibia, sometimes with ankle joint. Distal tibial fracture may range from injuries with little or no displacement to complex fractures with significant associated injuries. Stability of these injuries depends on a combination of boney and associated ligamentous injuries. Surgical management includes MIPO/Open procedure by distal tibial locking plate and screw, this may include distal fibula fracture. The surgical management steps far superior in different aspects of outcome for the patient as the patient needs early mobilization. Methods: This prospective study was conducted in Dept. of Orthopaedic and Trauma Surgery, Shaheed Monsur Ali Medical College and Hospital, Dhaka, Bangladesh from January 2021 to December-2022. During this study we have operated on total of seven patients with distal tibial fracture sometimes involving distal fibula. All of these patients came to ER with acute injuries following RTA, fall from height etc. All of these patients were assessed pre and post operatively. All of these cases were classified according to AO classification. Results: Total seven patients included. The mean age of the patients was 32.62± 2.24 years. Maximum study patient were injured from RTA. All of them were treated by minimally invasive and open procedure. Patients were kept on follow up at regular interval. All of the patient’s plasters were removed at around after 28th POD. On consequent follow up patients could walk after brief period of physiotherapy and active exercise. There was no significant difference in the distribution of AO/OTA classification, age, gender, AOFAS score, time from injury to operation, follow-up, bone union time, delayed union, malunion and infection (p>0.05). The operation time was significantly longer in the open group than in the MIPO group: 69.59±7.21 min. for the ORIF, and 61.14±5.61 for the MIPO group (p<0.01). The hospitalization .....