Abstract: Objective To evaluate the clinical effect of minimally invasive percutaneous plate osteosynthesis (MIPPO) combined with distal tibia locking plate in the treatment of middle and distal tibia fractures accompanied with severe soft tissue injury.Methods From October 2008 to December 2011,15 patients with middle or distal tibia fractures accompanied with severe soft tissue injury were treated in our department,using MIPPO combined with locking plate.Among them,10 were closed fractures and 5 were open fractures.Firstly,the soft tissue injury was treated immediately when admitted.Anti-inflammatory,dehydration was taken to close fractured patients,and debridement,anti-inflammatory was applied to open fractured patients.Operation would not perform until limb swelling subsided and there were no signs of infection.Closed reduction was accomplished first,and then a locking plate was inserted percutaneously and fixed the fracture on bridging mode.The wounds were covered with flaps after internal fixation for patients with open fractures.Results All cases were followed up for average 14.1 months (ranged from 12 to 20 months).The healing time of fractures was 17.3 weeks averagely (ranged from 12 to 28 weeks).No complications,such as nonunion,malunion and failure of the internal fixation,occurred in the cases.X-ray examinations were taken regularly.The function of ankles was evaluated at the end of follow-up according to the AOFAS Ankle-Hindfoot Scale,and 12 cases were excellent,2 were good and 1 was fair,the ratio of excellent and good was 93.3%.Conclusions MIPPO technique combined with locking plate is a clinically effective protocol for treating middle and distal tibia fractures,which benefits from its soft tissue protection,stable fixation,fewer complications and permit to early functional rehabilitation.

Key words: MIPPO, Locking plate, Distal tibia, Severe soft tissue injury