We evaluated the radiologic, clinical results and the complications of minimally invasive percutaneous medial plate fixation in distal tibial metaphyseal fracture. From January 2010 to December 2016, 31 patients with distal tibial fracture treated by medial plate fixation using Minimal Invasive Plate Osteosynthesis (MIPO) technique were analyzed. The duration of followup was more than 1 year. We evaluated clinical results by IOWA ANKLE rating system, union time by simple X-ray and complication. The bone union was achieved in all cases at average 16.7 weeks. Average IOWA ANKLE rating score was 90.3 point. At the last follow-up, there was no non-union, angular deformity more than 5 degrees or infection. We concluded that minimal invasive percutaneous medial plate fixation for distal tibial metaphyseal fractures is a safe and useful method if there is no medial wound problem, and it is important to pay close attention to prevent angular deformity during surgery.

We report the good results of two stage treatment in split depression type pilon fractures. A retrospective study of 9 cases among the 12 cases of split depression type pilon fractures from January 2009 to December 2015, who underwent two stage treatment of pilon fractures with minimum 24 months follow-up. And mean follow-up periods are 29 (24-41) months. In the first stage of the operation, reduction of articular surface using minial incision and external fixation were performed. As soft tissue heals, locking compression plate fixation was done with MIPO (Minimally Invasive Plate Osteosynthesis) technique. Radiographic evaluation was graded by the criteria of Burwell and Charnley. And functional assessment of ankle were evaluated by American Orthopaedic Foot and Ankle Society ankle-hindfoot score. Fractures were united in all cases within 17 (12-24) weeks. Radiologic results were showed anatomical reduction in 8 cases and the mean AOFAS score is 87.8 (80-96). The mean range of ankle motion is 44 degree. There are one superficial wound complications and 3 cases of ankle osteoarthritis. Two stage treatment of split depression type pilon fractures is one of the good treatment methods, because of definitive second stage operation is more easier after first stage opertation designed to get early anatomical reduction, and shows good radiological and clinical outcomes.