A Comparative Analysis of Infection Rates in Open Reduction and Internal Fixation Versus Minimally Invasive Plate Osteosynthesis for Closed Femur and Tibia Fractures (Code: T0004)

Introduction
Surgical site infections (SSIs) are a major challenge in orthopedic trauma care, particularly in the treatment of long bone fractures. The choice of surgical technique—open reduction and internal fixation (ORIF) or minimally invasive plate osteosynthesis (MIPO)—significantly impacts infection rates, recovery time, and overall outcomes. MIPO, which focuses on preserving the soft tissue envelope and minimizing surgical exposure, has gained attention as a potentially better alternative to ORIF in reducing postoperative complications and enhancing recovery. This study examines and compares the infection rates associated with ORIF and MIPO in the management of closed femur and tibia fractures.

AIM OF THE STUDY

To compare rate of infection in open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO) in closed femur and tibia fractures.

Methods
This prospective study was conducted at MMIMSR, Mullana, involving 50 patients with closed femur or tibia fractures. The participants were divided into two groups: 25 treated with ORIF and 25 with MIPO. Patients aged 20–70 years with closed fractures were included, while those with open fractures, pathological fractures, or systemic infections were excluded. Preoperative assessments included radiographic imaging and laboratory tests. Follow-ups were conducted at 4, 8, 16, and 24 weeks to monitor for infection, fracture union, and other complications. Data analysis was performed using SPSS version 27.

Results
Preliminary findings indicated a lower infection rate in the MIPO group (4%) compared to the ORIF group (18%). Patients treated with MIPO also experienced fewer complications, shorter operative durations, and reduced hospital stays. The higher infection rate in the ORIF group was attributed to extensive soft tissue manipulation and longer surgical times.

Conclusion
Minimally invasive plate osteosynthesis (MIPO) is associated with a lower risk of surgical site infections and superior postoperative outcomes compared to open reduction and internal fixation (ORIF) in closed femur and tibia fractures. These findings suggest that MIPO is a preferable technique for managing these fractures, particularly in settings where reducing infection risks and enhancing recovery are critical.