Determining the Outcomes of Pilon Fractures Treated by Minimally Invasive Plate Osteosynthesis (MIPO): A Retrospective Study.

BACKGROUND

Pilon fractures, affecting the distal tibia, pose significant challenges due to their complexity and the delicate balance required between adequate fracture reduction and soft tissue preservation. Minimally invasive plate osteosynthesis (MIPO) has emerged as a viable alternative to traditional open reduction and internal fixation (ORIF), aiming to reduce soft tissue complications while maintaining biomechanical stability.

OBJECTIVE

This study evaluates the functional and radiological outcomes of pilon fractures treated via MIPO, analyzes correlations between radiographic union and clinical scores, and investigates complication rates.

METHODS

We retrospectively analyzed 33 patients with AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) 43-B and 43-C pilon fractures treated using MIPO from February 2023 to January 2024 at RL Jalappa Hospital and Research Centre, Kolar, India. Functional outcomes were measured using the American Orthopaedic Foot & Ankle Society Hindfoot Score (AOFAS), Olerud and Molander Ankle Score (OMAS), and visual analog scale (VAS) scores. Radiological union was assessed using the modified Radiographic Union Scale for Tibial fractures (mRUST). Statistical analyses included Kruskal-Wallis, Mann-Whitney U, chi-square, and Fisher's exact tests.

RESULTS

Results suggest favorable functional recovery (mean AOFAS score: 85.2 ± 8.6) and a low complication rate (9.1%, n=3, N=33). Radiological union was achieved in 93.9% (n=31, N=33) of cases by six months.

CONCLUSION

MIPO demonstrates favorable functional and radiological outcomes in pilon fractures with reduced soft tissue complications. Further multicentric studies are warranted to validate long-term efficacy.