Outcomes of Minimally Invasive Plate Osteosynthesis in Tibial Shaft Fractures

Abstract

Introduction:: Tibial shaft fractures are among the most commonly encountered long bone injuries, often associated with high-energy trauma. Minimally Invasive Plate Osteosynthesis (MIPO) has emerged as a promising technique for their management, aiming to preserve soft tissue integrity and promote biological healing through limited surgical exposure.Objectives:To evaluate the functional and radiological outcomes of tibial shaft fractures managed using the MIPO technique at a tertiary care centre in South India.Methodology:A prospective observational study was conducted on 50 adult patients with closed or Grade I open tibial shaft fractures at a tertiary care institute from May 2023 to May 2024. All patients underwent MIPO using pre-contoured locking plates. Clinical and radiological assessments were performed at regular intervals, and functional outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring system. Statistical analysis was performed using SPSS version 25.0, with significance set at p < 0.05.Results:The mean time to radiological union was 15.8 ± 3.2 weeks. AOFAS scores at 24 weeks indicated excellent outcomes in 56% of patients, good in 30%, fair in 12%, and poor in 2%. The mean knee flexion achieved was 128.5°, and complication rates were low, with only 6% superficial infections and 4% delayed union. Statistically significant associations were observed between functional outcome and age, fracture type, pattern, and presence of complications (p < 0.01).Conclusion:MIPO is a reliable and efficient technique for the treatment of tibial shaft fractures, offering favourable union rates, excellent functional recovery, and minimal complications. Its application in tertiary care settings can significantly enhance outcomes in fracture management.