Gravity-Based Minimal Invasive Plate Osteosynthesis for Proximal Tibia Fractures: A Novel Reduction Technique

Minimally Invasive Plate Osteosynthesis (MIPO) is widely utilized in treating extra-articular proximal tibia fractures due to its advantages in preserving periosteal blood supply, reducing pain, and promoting early functional recovery. Traditional techniques, such as external fixators and manual traction, often involve extended surgical times, increased risk of infection, and additional costs. This study introduces a novel gravity-based reduction technique for extra-articular proximal tibial fractures to enhance the efficiency and safety of MIPO procedures. We evaluated this technique in a cohort of three male patients (aged 26, 34, and 56) with extra-articular comminuted proximal tibial fractures, all resulting from motorcycle accidents. Patients were positioned supine on a conventional operating table, with the affected limb suspended vertically, allowing gravity-assisted reduction. The average surgical time was 35 ± 8 minutes. All patients achieved complete bone union within 24 weeks, with no intraoperative or postoperative complications, and returned to work in less than 10 days. This gravity-based reduction technique demonstrates promising results in reducing operative time and complications, suggesting it may be a valuable alternative to traditional methods. However, further studies with larger sample sizes are needed to validate these findings and assess long-term outcomes.