Indirect reduction technique using a distraction support in minimally invasive percutaneous plate osteosynthesis of tibial shaft fractures

PURPOSE: To describe an indirect reduction technique during minimally invasive percutaneous plate osteosynthesis (MIPPO) of tibial shaft fractures with the use of a distraction support. METHODS: Between March 2011 and October 2014, 52 patients with a mean age of 48 years (16–72 years) sustaining tibial shaft fractures were included. All the patients underwent MIPPO for the fractures using a distraction support prior to insertion of the plate. Fracture angular deformity was assessed by goniometer measurement on preoperative and postoperative images. RESULTS: Preoperative radiographs revealed a mean of 7.6°(1.2°–28°) angulation in coronal plane and a mean of 6.8°(0.5°–19°) angulation in sagittal plane. Postoperative anteroposterior and lateral radiographs showed a mean of 0.8°(0°–4.0°) and 0.6°(0°–3.6°) of varus/valgus and apex anterior/posterior angulation, respectively. No intraoperative or postoperative complications were noted. CONCLUSIONS: This study suggests that the distraction support during MIPPO of tibial shaft fractures is an effective and safe method with no associated complications.