Minimally Invasive Plate Osteosynthesis for Comminuted Fractures of Long bones: A Prospective Study on Outcomes and Complications

The surge in comminuted bone fractures, attributed to modern lifestyles and increased trauma incidents, poses significant challenges in management. Traditional open reduction and plating methods, while effective, are associated with drawbacks like delayed union and higher infection rates. The evolution of MIPO (Minimally Invasive Plate Osteosynthesis) seeks to overcome these limitations. The potential effects of MIPO in the management of severely comminuted long bone fractures are investigated in this work. The Saveetha Medical College's Department of Orthopaedics carried out a prospective study from March 2022 to March 2024. Patients aged 20 to 60 with fractures of the femur, tibia, and humerus resulting from road traffic accidents were included. The AO Fracture classification system was utilized, and MIPO techniques were employed for fixation. Clinical and radiological assessments were conducted at various follow-up intervals. Statistical analysis using IBM SPSS Version 22.0 assessed outcomes, with a P-value<0.05 countedas significant. MIPO was performed on twenty-four male patients, ages averaging 34.4 years, for severely comminuted fractures. The distal 1/3 of the femur, the tibia, and the humerus shaft were among the fractures. Union was rapid in 15 cases, with delayed consolidation in two requiring secondary bone grafting. Functional outcomes assessed using the Neer–Grantham–Shelton Criteria, demonstrated excellent outcomes- 65%, good- 30%, and fair- 5% of events. Complications included infection (5%), wound gaping (5%), joint stiffness (25%), and limb length discrepancy (20%). This study reinforces MIPO as a promising approach for severely comminuted fractures, showcasing excellent union rates and functional outcomes. Studies highlight its advantages in preserving soft tissue and periosteal circulation. The shift from anatomic reduction to optimal stability in such fractures aligns with current trends. Complications, though present, are manageable. The study contributes to the growing body of evidence supporting MIPO, emphasizing its potential advantages in minimizing surgical trauma and maintaining biological stability. Further research, including comparative studies and exploration of other fixation methods, is warranted for a comprehensive understanding of MIPO's role in fracture management.