{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T07:14:32Z","timestamp":1783322072172,"version":"3.54.6"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Second to minimally invasive plates osteosynthesis (STMIPO) is a novel surgical technique that combines the small incision, minimally invasive, and aesthetic advantages of minimally invasive plate osteosynthesis (MIPO) with the direct visualization fracture reduction of open reduction and internal fixation (ORIF). This study primarily evaluates the clinical efficacy of STMIPO in the treatment of distal one-third fibular fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 145 fibular fracture patients treated in our orthopedic department from January 2021 to December 2023. All surgeries were performed by two main surgeons; one used open reduction and internal fixation (ORIF group), and the other used STMIPO technique (STMIPO group). The study compared the ORIF and STMIPO groups in terms of operation time, fracture healing time, intraoperative blood loss, length of incision, postoperative ankle AOFAS score for isolated fibular fractures, and postoperative complications (such as wound infection, plate exposure, delayed bone healing, and hardware-related pain).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average follow-up time was 17.12\u2009\u00b1\u20092.66 months (weighted average of the two groups), during which all patients achieved osseous union of the fibula. Statistical analysis showed that the STMIPO group had advantages over the ORIF group in terms of surgical incision length, intraoperative blood loss, and postoperative complications. There was no significant difference between the two groups in postoperative ankle AOFAS scores for isolated fibular fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>STMIPO technique, as a new minimally invasive fracture treatment technique, has demonstrated significant advantages in the treatment of distal one-third fibular fractures, including smaller surgical incisions, minimal damage to surrounding tissues, faster postoperative recovery, and comparable fracture healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Therapeutic Level III.<\/jats:p>\n                  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