Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis

Abstract

Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012-2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats' ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

Biomechanical Comparison of Two Locking Plate Constructs for the Stabilization of Feline Tibial Fractures

“…17,37,38 If CCP are to be used in tibial fractures that are unable to be reconstructed, supplemental fixation in the form of an intramedullary pin or orthogonal plate may be advisable. 39,40 Further clinical investigation of both plating systems is warranted to determine optimal applications when stabilizing tibial fractures in cats.…”

Comparison of Outcomes from Minimally Invasive Plate Osteosynthesis (MIPO) Versus Open Reduction and Internal Fixation (ORIF) in Radial Fracture Gap Models

“…And in present study, there were no significant intra-or postoperative complications with either procedure. According to reports from human medicine, postoperative complications with MIPO occur rarely and include superficial or deep infection, screw loosening or breakage, implant failure, delayed union, nonunion, and mal-aligned union (Hasenboehler et al, 2007;Ronga et al, 2010;Buckley et al, 2011;Craig et al, 2018;Townsend and Lewis, 2018). Several studies have reported the rate of delayed union or non-union to be 5-17% (Hasenboehler et al, 2007).…”

“…Instead, it applies a bone plate as a bridge fashion without surgically approaching the fracture site (Peirone et al, 2012). Recently, the use of MIPO has been reported for the treatment of radius and tibia fractures in small dogs and cats to reduce iatrogenic vascular destruction (Hudson et al, 2012;Pozzi et al, 2013;Craig et al, 2018). The purpose of this study was thus to compare the clinical and functional outcomes through radiographic evaluation, visual lameness scoring, weight bearing time and range of motion between ORIF and MIPO in radial fracture gap models.…”

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

“…The authors are not aware of any study focusing on the benefits/limitations of an OBDNT approach compared with other methods. Numerous MIO techniques are reported in the veterinary literature for the treatment of long bone fractures, including external skeletal fixation, minimally invasive plate osteosynthesis (MIPO), and interlocking nails . Minimally invasive osteosynthesis techniques have also been applied to articular fractures, sacroiliac joint luxation stabilization, and central tarsal bone luxation stabilization .…”

“…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 .…”