Minimal Invasive Plate Osteogenesis (MIPO) by the Use of Locking Compression Plate as External Fixator for Fracture Shaft of Tibia : The Surgical Outcome in Phichit Hospital

Authors

  • Naiyarat Latthitithum

Abstract

Conventional plating principle that to obtain anatomical reduction and rigid internal fixation may require extensive subperiosteum exposure and can result in the devitalization of blood supply to the surrounding soft tissues and may result in development of delay union and non-union .The new concept of Minimal Invasive Surgery is the preservation of the biological environment  of the fracture site. During the first week following the fracture, an inflammatory response, dominated by angiogenesis and controlled by hypoxemia resulting from local vascular damages takes place at the fracture site, leading to the formation of an early fibro-cartilaginous callus, which has been demonstrated  to be vitally important in optimizing bone healing. The principle of Minimal Invasive Surgery has been associated with several alterations of traditional plating techniques among which the use of longer plate(bridging plate), a decrease in the number of screws, remoted incision to the fracture site, slide a bone plate over the fracture, no need for anatomical reduction and bone graft. The objective of this study was to evaluate  the surgical outcome of MIPO technique (Minimal Invasive Plate Osteogenesis) by the use of Locking Compression Plate (LCP) as external fixator in treatment fracture shaft of tibia by the author, in Pichit Hospital from 16February 2006-27 December 2006.The result was 5 patients included in this study (4 men and 1 woman) ; age 15-29 years (average 22.20 ± 6.53yrs.) ; no alcohol drinking no smoking ; Winquist classification of comminution type I -2 pts, type II   -3  pts, type III -0 pts, type  IV -0 pts ; traffic accident  2 pts, occupational injury 2 pts, sport injury 1 pt ; time to surgery was 4-28 days (average 11.20 ± 10.47days) ; time of admission was 6-19 days (average 11.60 ± 5.94 days) ; time of surgery 60-135 minutes(average 94.00 ± 35.60 minutes);blood loss was 0 cc.;time to union 4-14 weeks(average 9.80 ± 4.91weeks)  ; time to off plate was 17-28 weeks (average 21.40± 4.39 weeks). The result of treatment approved by Criteria for Evaluation of Final Results from Johner and Wruhs was found to be excellent in all patients.

Published

2020-05-29

Issue

Section

Original Article