Minimally Invasive Plate Osteosynthesis (MIPO) technique for complex tibial shaft fracture


Complex tibial shaft fracture, Minimally Invasive Plate Osteosynthesis, Temporary external fixation, Locking compression plate

Published online: Jul 15 2019

Sungwook Choi , Tong Joo Lee , Shinil Kim , Changhee Cho , Seungjae Shim , Hyunseong Kang

From the Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, South Korea


TTo evaluate the clinical and radiological results of the treatment of complex tibial shaft fracture (AO/OTA type 42-C) with minimally invasive plate osteosynthesis(MIPO).

Twenty patients diagnosed with complex tibial shaft fracture without extension to the articular surface and treated with MIPO, including 9 cases of AO/ OTA type 42-C2 and 11 cases of AO/OTA type 42-C3, 6 of which were open fractures. External fixation was used for open fractures until the soft tissue damage had healed; then, 2nd stage operation with MIPO was performed to stabilize the fracture. Each patient was followed up for a minimum of 12 months.

The mean time to union was 20.1 weeks. Delayed union was observed in 4 cases. Angular deformity, length shortening and non-union were not observed. Severely comminuted and open fractures of the tibial shaft may benefit from temporary external fixation prior to performing MIPO.