Comparison between antegrade intramedullary nailing (IMN), open reduction plate osteosynthesis (ORPO) and minimally invasive plate osteosynthesis (MIPO) in treatment of humerus diaphyseal fractures

Kulkarni, Vidisha; Kulkarni, Madhura Sujay; Kulkarni, Govind S; Goyal, Vaibhav; Kulkarni, Milind G

doi:10.1016/s0020-1383(17)30487-4

Cited by 37 publications

(33 citation statements)

References 39 publications

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“…Nine percent of respondents in our survey reported that longer operating times was the most significant perceived limitation to performing MIPO compared with a more traditional approach. In one study in the human literature, Kulkarni and colleagues showed that operating time was largely dependent on surgeon skill and experience. The authors of this latter study concluded that an individual‐specific approach should be used in each case despite the benefits shown with a MIPO approach compared with an interlocking nail or an open approach and rigid internal fixation .…”

Section: Discussionmentioning

confidence: 99%

“…In one study in the human literature, Kulkarni and colleagues showed that operating time was largely dependent on surgeon skill and experience. The authors of this latter study concluded that an individual‐specific approach should be used in each case despite the benefits shown with a MIPO approach compared with an interlocking nail or an open approach and rigid internal fixation . Until clear evidence can be provided that one approach is significantly more effective than another, the authors suggest that decisions be made on a case by case basis.…”

Section: Discussionmentioning

confidence: 99%

“…Minimally invasive osteosynthesis techniques have also been applied to articular fractures, sacroiliac joint luxation stabilization, and central tarsal bone luxation stabilization . Reported advantages of MIO/MIPO techniques in human and veterinary patients include reduced postoperative pain, preservation of the fracture hematoma, improved vascularization of the fracture site, more rapid healing, fewer wound complications, and faster return to normal function compared with open approaches . Disadvantages reported include the technical difficulty of the learning process, longer operating times, prolonged healing, fracture malreduction, and radiation safety issues associated with intraoperative fluoroscopy .…”

Section: Introductionmentioning

confidence: 99%

“…Disadvantages reported include the technical difficulty of the learning process, longer operating times, prolonged healing, fracture malreduction, and radiation safety issues associated with intraoperative fluoroscopy . Because of the conflicting evidence, Kulkarni et al advocated an individual approach to each fracture based on a cost/benefit analysis.…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of minimally invasive osteosynthesis: A 2018 survey of orthopedic surgeons

et al. 2019

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Objective To report perspectives of minimally invasive osteosynthesis (MIO) techniques in veterinary surgical practice in 2018. Study design Electronic questionnaires. Sample population Diplomates and residents of the American College of Veterinary Surgery and European College of Veterinary Surgery and members of the Veterinary Orthopedic Society. Methods Survey questions pertaining to MIO and minimally invasive plate osteosynthesis (MIPO) were sent electronically to the sample population. Questions assessed training, current caseload, benefits, and limitations of MIO and MIPO. Results Two hundred fifty‐six veterinary surgeons completed questions pertaining to MIO, and 238 veterinary surgeons completed questions pertaining to MIPO. With regard to MIO, only 16% of respondents reported that they performed MIO regularly or exclusively, and 62% wanted to perform more MIO than they were currently undertaking. Tibial fractures were most commonly selected for MIO/MIPO stabilization techniques in both cats and dogs. Challenges in achieving adequate fracture reduction were identified as the greatest limitations of MIO/MIPO techniques. Forty‐three percent of respondents felt there were not enough MIPO training opportunities. Conclusion Currently, MIO/MIPO techniques are performed infrequently, with a large proportion of respondents revealing that they would like to perform more in the future. There is also evidence that additional training opportunities would be welcomed for MIPO. Clinical significance The results of our survey provide evidence that, despite the benefits of MIO and MIPO compared with more traditional fracture stabilization approaches, significant barriers must be overcome before the techniques are likely to be more widely adopted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perceptions of minimally invasive osteosynthesis: A 2018 survey of orthopedic surgeons

et al. 2019

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“…Disadvantages of MIO include exposure of the operating team to radiation from intraoperative fluoroscopy and a steep learning curve 5‐11 . Challenges of MIO include the inability to visualize the fracture ends, changes of the normal anatomic structures secondary to fracture displacement and soft tissue swelling, difficulty and increased time required to overcome muscle contractions countering satisfactory fragment reduction and alignment, the requirement to rely on implant placement based on regional anatomical landmarks remote from the fracture site, reliance on surgical experience, and risk of inadvertent loss of reduction prior to having secured the final implant 11‐14 . Therefore, MIO may increase the risk of inducing iatrogenic limb malalignment or inappropriate implant placement, which could impact clinical outcomes or require additional surgery 3,4,15‐22 .…”

Section: Introductionmentioning

confidence: 99%

Development of a novel fracture fragment stabilization system for minimally invasive osteosynthesis and in vitro comparison to traditional Kern bone reduction forceps

Pfeil

Horstman

2020

Veterinary Surgery

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Objective: To develop and evaluate a novel fracture fragment stabilization system, the Sirius minimally invasive bone reduction handle system (SMH), in an artificial fracture model (FxM) simulating a canine femoral fracture repair with a minimally invasive orthopedic approach. Study design: In vitro experimental study. Sample population: Synthetic fractured femurs with soft-tissue coverage analog (n = 8). Methods: The developed SMH consisted of modified Kern forceps connected with existing external skeletal fixation components. Intramedullary Steinman pin placement with the SMH or traditional Kern forceps only (KO) was performed by 16 participants in randomized order. Demographics and surgical experience of participants and outcome variables (fragment movement, early/ final gap formation, time of procedure, assessed practicability by visual analog scale) were recorded and statistically evaluated. Results: The SMH was more difficult and took longer to assemble (P = .031 and P = .008); SMH resulted in a smaller final reduction gap (P = .008). More surgical experience resulted in faster surgery times (R 2 = 0.766) but was not correlated with final fracture gap formation. Conclusion: The SMH was associated with reduced fragment gap formation in this simulated setting. Clinical significance: The SMH may be helpful for maintaining reduction of femoral fractures in dogs. Additional studies of the SMH should be conducted to fully assess the effectiveness and practicality in clinical cases. 1 | INTRODUCTION Minimally invasive osteosynthesis (MIO) and its advantages are well described. 1-4 Disadvantages of MIO include exposure of the operating team to radiation from intraoperative fluoroscopy and a steep learning curve. 5-11 Challenges of MIO include the inability to visualize the fracture ends, changes of the normal anatomic structures secondary to fracture displacement and soft tissue swelling, difficulty and increased time required to overcome

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Antegrade und retrograde Nagelung von Humerusschaftfrakturen

Hessmann

Mittlmeier

2021

Oper Orthop Traumatol

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Comparison between antegrade intramedullary nailing (IMN), open reduction plate osteosynthesis (ORPO) and minimally invasive plate osteosynthesis (MIPO) in treatment of humerus diaphyseal fractures

Cited by 37 publications

References 39 publications

Perceptions of minimally invasive osteosynthesis: A 2018 survey of orthopedic surgeons

Perceptions of minimally invasive osteosynthesis: A 2018 survey of orthopedic surgeons

Development of a novel fracture fragment stabilization system for minimally invasive osteosynthesis and in vitro comparison to traditional Kern bone reduction forceps

Antegrade und retrograde Nagelung von Humerusschaftfrakturen

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