Role of biological plating in comminuted long bone fractures: a prospective study

The concept of biological osteosynthesis refers to the conservation of vascularity of the bone during surgical intervention to ensure the continued vitality of the individual fragments and to achieve improved fracture healing. Main principle of biological fixation by minimally invasive percutaneous plate osteosynthesis (MIPPO) in long bone fractures is relative stability which is provided by using long plate with limited number of screws. Some biomechanical studies have been reported about this issue. However, clinical studies are still missing. The aims of this prospective study were to evaluate the clinical and radiological results of adult tibia fractures treated by MIPPO. Materials and Methods: A prospective study was conducted with in a period of one and a half year; from Jan. 2015 to May 2016 on 60 patients who presented to emergency wing of. orthopaedic deptt in a tertiary care centre in northern India ,during this period. In our series of 60 patients most of the patients were in the age group of 25-40 years, average age was 35.7 years.RTA accidents accounted for 50% of cases in our series. Most of the patients had a follow up ranging from 6-15 months. Patients were assessed as per the criterion laid down by S.J Lam at each follow up Most of the patients (70%) had radiological union between 16-25 weeks. Out of 30 patients, 4 patients of fracture humerus were not assessed in this group.2 pateints with deep wound infection and infected non union did not ambulate and is still under treatment for infection and non union. Conclusion: MIPPO technique provides good bone healing and decreases incidence of nonunion and need for bone grafting. The technique of biological plating can be used in fractures where locked nailing cannot be done like vertical slit and markedly comminuted fractures.