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Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 34-37 | Rakesh Sharma, Rajesh Kapila, Sarika Kapila, Dharam Singh, Jagsir Mann doi-10.13107/ti.2018.v04i01.064 Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] . [1] Department of Orthopaedics, Govt. Medical College, Amritsar – 143001 (Punjab). India [2] Dept. Of […]

Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page:4-6 | Dheenadhayalan Jayaramaraju, Raja Bhaskara Rajasekaran, Devendra Agraharam, Ramesh Perumal. doi-10.13107/ti.2018.v04i01.056 Author: Dheenadhayalan Jayaramaraju [1], Raja Bhaskara Rajasekaran [1], Devendra Agraharam [1], Ramesh Perumal [1]. [1] Department of Orthopaedics & Trauma Ganga Medical Centre & Hospitals Pvt. Ltd, 313, Mettupalayam road, Coimbatore, India […]

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Full Sized Blog Element (Big Preview Pic)

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 34-37 | Rakesh Sharma, Rajesh Kapila, Sarika Kapila, Dharam Singh, Jagsir Mann

doi-10.13107/ti.2018.v04i01.064

Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] .

[1] Department of Orthopaedics, Govt. Medical College, Amritsar – 143001 (Punjab). India

[2] Dept. Of Oral and Maxillofacial Surgery, SGRD institute of dental sciences. Amritsar

Address of Correspondence
Dr. Rajesh Kapila

2-B , circular road, Amritsar-143001
Email: kapila.rajesh@ yahoo.com

Abstract

Background: The limited soft tissue, subcutaneous location of large portion of tibia and precarious blood supply renders the treatment of distal tibial fracture very challenging. The main treatment of this type of fracture is reinstatement of the normal alignment and articular congruity. Conventional osteosynthesis is not suitable because distal tibia is subcutaneous bone with poor vascularity. Closed Reduction and MIPPO with locking compression plate (LCP) has emerged as an alternative treatment option because it respects biology of distal tibia, maintains fracture haematoma and provides biomechanically stable construct, early mobilization, less complications and relatively higher rates of union. The aim of this study was to evaluate the functional and clinical outcomes of distal tibia fracture of patients, treated by internal fixation by minimally invasive plating osteosynthesis (MIPPO) technique with locking compression plate (LCP).
Methods: 50 patients with distal tibia fracture with or without intra articular extension were treated in our department, with MIPO with LCP and were prospectively followed for average duration of 6 months. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) score ( Ankle – Hindfoot Scale )
Results: There were 50 patients (36 males and 14 female) with mean age of 38.4 years. The mean follow up period of our patients was 6 months. All fractures united at an average of 19.13 weeks (range- 16-24 to weeks) except two cases of non- union. There were 8 superficial wound infections which were treated with oral antibiotics and progressed to union and there were no failures of implants. According to AOFAS score at 6 months, 6 cases had score of 31 to 70 and 44 cases had score of 71 to 100.
Conclusions: Minimally invasive plating osteosynthesis (MIPPO) is an effective method of treatment for distal tibial fractures. The use of indirect reduction techniques and small incision is technically demanding and it is effective, minimally invasive, optimises the operation time, promotes early healing and reduces the incidence of infections and complications associated with conventional method of open reduction and internal fixation.
Keywords: Distal tibia, LCP, MIPPO, Osteosynthesis, Plating.

References

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How to Cite this article: Sharma R, Kapila R, Kapila S, Singh D, Mann J.Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures. A Prospective Study of 50 Cases. Trauma International May-Aug 2018;4(1):34-37.

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Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page:4-6 | Dheenadhayalan Jayaramaraju, Raja Bhaskara Rajasekaran, Devendra Agraharam, Ramesh Perumal.

doi-10.13107/ti.2018.v04i01.056

Author: Dheenadhayalan Jayaramaraju [1], Raja Bhaskara Rajasekaran [1], Devendra Agraharam [1], Ramesh Perumal [1].

[1] Department of Orthopaedics & Trauma Ganga Medical Centre & Hospitals Pvt. Ltd, 313, Mettupalayam road, Coimbatore, India

Address of Correspondence
Dr. Raja Bhaskara Rajasekaran,
Ganga Hospital, Mettupalayam road,Coimbatore, India
Email: rajalibra299@gmail.com

Abstract

Primary management of open injuries is of utmost importance as it has direct implication on the functional outcome. Strict adherence to the ATLS protocol followed by appropriate splintage of the limb must be done. While antibiotics need to be given within 3 hours since injury, wound lavage and wound cultures have no role. Documentation and adequate counselling regarding the complications also needs to be done while managing every case of open injury.
Keywords: Open injury, antibiotic prophylaxis, wound lavage, limb splintage

References

1. Dabezies EJ and D’Ambrosia RD. Treatment of the multiply injured patient: plans for treatment and problems of major trauma. Instructional course lectures 1984; 33: 242-52.
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3. Initial Management of Open Fractures. (Book Chapter) S. Rajasekaran et al. Rockwood and Green’s Fractures in Adults. Eigth Edition. Vol 1 :353-396.
4. Kreder HJ and Armstrong P. The significance of perioperative cultures in open pediatric lower-extremity fractures. Clinical orthopaedics and related research 1994: 206-12.
5. Lee J. Efficacy of cultures in the management of open fractures. Clinical orthopaedics and related research 1997: 71-5.
6. Gosselin RA, Roberts I, Gillespie WJ. 2004: Antibiotics for preventing infection in open limb fractures. Cochrane Database Syst Rev; Issue 1: Cd003764.
7. BAPRAS Guidelines: Standards for management of open fractures of the lower limb. 2009

How to Cite this article: Dheenadhayalan J, Rajasekaran R B, Agraharam D, Ramesh Perumal R. Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines. Trauma International May -Aug 2018;4(1):4-6.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

Full Sized Blog Element (Big Preview Pic)

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] .

Abstract

References

(Abstract Text HTML) (Download PDF)

Primary Management and Antibiotic Prophylaxis in Open Injuries of the Lower Limb: Current guidelines

Author: Dheenadhayalan Jayaramaraju [1], Raja Bhaskara Rajasekaran [1], Devendra Agraharam [1], Ramesh Perumal [1].

Abstract

References

(Abstract Text HTML) (Download PDF)

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