Introduction: To compare the results of plating by Minimally Invasive Plate Osteosynthesis (MIPPO) technique and Interlocking intramedullary nailing (IMN) in various aspects in extra-articular fracture of the proximal tibia.
Methods: This prospective study included 68 patients with extra-articular proximal tibia fractures. They included Grade 1 and Grade 2 compound fractures and closed 41A2 and 41A3types fractures.34 were treated with IMN and 34 by MIPPO technique. They were followed up for one year and results were analyzed according to Knee Society Score, Lower Extremity Functional Scale (LEFS) and “Johner & Wruhs Criteria”.
Results: The union rate after index procedure was 88.23% in MIPPO and 90% in IMN group. The mean time for the union in MIPPO group was 15.6 weeks and that for IMN group was 15.4 weeks. Postoperative mal-alignment in MIPPO was; Varus (2.94%), Apex Anterior (5.88%) and Apex Posterior (2.94%) and in IMN group: Varus(3.33%), Valgus(3.33%) and Apex Anterior (1%).In MIPPO there was 11.76% superficial infection as compared to 2.67% in IMN group. Implant irritation was 5.88% in MIPPO and Knee pain (6.67%) was common in IMN group. Malunion was 11.76% in MIPPO and 16.67% in IMN group. KSS in MIPPO was 81.70 and in IMN group was 84.30. The average LEFS was 65.16 for MIPPO and 67.05 for IMN group. The one year follow up Johner and Wruhs score was excellent to good in 82.36% in MIPPO and 90% in IMN group.
Conclusion: Both the treatment methods showed promising and adequate fracture stability in extra-articular proximal fracture provided care is taken to prevent infection, delayed union, nonunion and malunion.
