Minimally invasive percutaneous plate osteosynthesis in treatment of diaphyseal tibial fractures without the use of image intensifier – a study of 30 cases

Objective: The aim of our study was to evaluate the results of diaphysealtibial fractures, treated with minimally invasive percutaneous plate osteosynthesis without use of the image intensifier, in the terms of rate of union of the fracture, range of motion and rate of complications. Materials and Methods: 30 patients (25 males, 5 females) who were operated upon using the minimally invasive percutaneous plate osteosynthesis (MIPPO) principles without the use of image intensifier for tibial diaphyseal fractures. After indirect reduction, the plate was advanced through a sub muscular extraperiosteal tunnel without opening of the fracture site. The plate was fixed using screws through the incisions made at the proximal and distal ends. Clinical and radiological evaluations were made after surgery. Full weight bearing was allowed after an average of 21.66 weeks. Duration of union and complications were analyzed. Results: The mean duration of union was 19.4 weeks. All cases showed union but malunion occurred in two cases. Conclusion: MIPPO without the use of image intensifier is a very effective alternative treatment for tibial diaphyseal fractures showing high union rates, low complications and no risk of radiation exposure.