A Comparative Study between Minimally Invasive Plate Osteosynthesis versus Open Reduction and Internal Fixation for Distal Third Tibia Fractures

Abstract

Background: Despite the array of surgical and non-surgical approaches available for treating distal tibia fractures, managing unstable fractures continues to pose a challenge. This study aims to compare the advantages and clinical outcomes of the Minimally Invasive Plate Osteosynthesis (MIPO) and Open Reduction and Internal Fixation (ORIF) in managing distal third tibia fractures.

Material and method: Our study focused on 60 cases selected based on age and fracture type. A comparative analysis was conducted between the two groups, considering factors such as age, gender, AO fracture type, length of hospital stay, surgical duration, complication rates, time to return to routines, and adherence to the American Orthopaedic Foot and Ankle Surgery (AOFAS) criteria. Statistical analyses were carried out using R-Studio software version 2023.06.1.

Result: The blood loss during surgery was significantly more in the ORIF group (142 ± 56.83 ml vs. 81.83 ± 37.63 ml) (P < 0.05). The incidence of complications was significantly higher in the ORIF group than MIPO group (P < 0.05). Time for back to routines was significantly shorter in the MIPO group (17.63 ± 7.86 weeks vs. 22.36 ± 8.81 weeks) (P < 0.05). There was no significant difference about duration of surgery, time of hospitalization, bone union time, and AOFAS score between the MIPO and ORIF groups.

Conclusion: The optimal method for managing distal tibia fractures remains uncertain due to discrepancies between the outcomes of MIPO and ORIF. We favor MIPO due to its potential for early bone union, quicker return to normal activities, and reduced risk of wound complications.