• Nasir Muzaffar, Rafiq Bhat, and Mohammad Yasin.
• Bone and Joint Surgery Hospital, Barzalla, Srinagar, Kashmir, India.
• Arch Trauma Res. 2014 Sep 1; 3 (3): e18325.

BackgroundPlate on plate technique can lessen operative time and patient morbidity.ObjectivesThis study aimed to evaluate the outcomes of minimally invasive percutaneous plate osteosynthesis (MIPPO) using plate on plate technique of locking plate fixation for closed fractures of distal tibia in a prospective study.Patients And MethodsTwenty-five patients with distal tibial fractures were treated by MIPPO using locking plate by plate on plate technique. Preoperative variables including age of patient, mode of trauma, type of fracture and soft tissue status were recorded for each patient. Perioperative variables included surgical time and radiation exposure. Postoperative variables included wound status, time to union, return to activity and the American orthopaedic foot and ankle score (AOFAS).ResultsAll the fractures had united at one year. The average time to union was 16.8 weeks. There were two cases of superficial infection and two cases of deep infection, which required removal of hardware after the fracture was united. The average AO foot and ankle score was 83.6 in our study population.ConclusionsMIPPO using locking plate by plate on plate technique was a safe, effective, inexpensive and easily reproducible method for the treatment of distal tibial fractures in properly selected patients, which minimized operative time and soft tissue morbidity.

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