# A Study of Functional Outcome of Proximal Tibia Fractures Treated With Minimally Invasive Percutaneous Plate Osteosynthesis Technique: A Prospective Study

## TL;DR

This study shows that a minimally invasive surgical technique effectively treats complex tibial fractures with good recovery and few complications.

## Contribution

Demonstrates the effectiveness of MIPPO with locking compression plates for proximal tibial fractures in a prospective clinical setting.

## Key findings

- Most patients achieved excellent to good functional outcomes with satisfactory knee motion.
- Average radiological union time was 20 weeks with minimal complications like infection and stiffness.

## Abstract

Background

Proximal tibial fractures are complex periarticular injuries that commonly result from high-energy trauma and are frequently associated with articular incongruity, instability, and long-term functional impairment. Restoration of joint congruity, along with preservation of the soft tissue envelope, is essential to achieve a satisfactory outcome. Minimally invasive percutaneous plate osteosynthesis (MIPPO) has gained popularity because it provides stable fixation while preserving fracture biology and minimizing complications related to extensive surgical exposure.

Materials and methods

A prospective observational study was conducted on 35 adult patients with closed proximal tibial fractures treated with locking compression plates using the MIPPO technique. Patients were evaluated clinically and radiologically at regular intervals for up to six months postoperatively. Functional outcomes were assessed using the modified Rasmussen functional score, and pain severity was measured using the visual analog scale (VAS). Radiological union, range of motion, and complications were also documented.

Results

The mean age of the patients was in the fourth decade, with a male predominance. Road traffic accidents were the most common mechanism of injury. Most fractures were classified as Schatzker type IV and V patterns. The average radiological union time was approximately 20 weeks. The mean VAS score progressively decreased, while the modified Rasmussen score significantly improved during follow-up. At the final evaluation, the majority of patients achieved excellent to good functional outcomes with a satisfactory range of motion in the knee. Complications were minimal and included isolated cases of superficial infection, stiffness, and malalignment.

Conclusion

MIPPO, utilizing a locking compression plate, offers reliable fixation for proximal tibial fractures while preserving vascularity and the fracture hematoma. This technique enables early mobilization, promotes predictable fracture union, and yields favorable functional outcomes with a low complication rate, making it an effective treatment modality for peri-articular proximal tibial injuries. This study has been reported in accordance with the STROBE guidelines for observational studies.