Minimally Invasive Plate Osteosynthesis

Schmierer, Philipp A; Pozzi, Antonio

doi:10.1002/9781119380139.ch5

Cited by 4 publications

(5 citation statements)

References 49 publications

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“…For closed reduction with 3DRG, a craniolateral MIPO approach to th previously described, was performed at the planned site [11][12][13] (Figure 4A,B cles and soft tissues at the site of placement of the base guides were dissect bones. The base guide was held in place manually or using bone-holding fo drill sleeve (ABLE Inc., Jeonbuk, Republic of Korea) was placed onto the bas inder, and the radius was drilled by using a 0.8 drill bit (ABLE Inc.).…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…For closed reduction with 3DRG, a craniolateral MIPO approach to the radius, as previously described, was performed at the planned site [11][12][13] (Figure 4A,B). The muscles and soft tissues at the site of placement of the base guides were dissected from the bones.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…After the plate placement, reduction was assessed using fluoroscopy (Figure 5). The open reduction technique and closed reduction technique with a circular external skeletal fixator (ESF) were performed as previously described [5,[12][13][14].…”

Section: Surgical Proceduresmentioning

confidence: 99%

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Evaluation of a 3D-Printed Reduction Guide for Minimally Invasive Plate Osteosynthesis of Short Oblique Radial Diaphyseal Fracture in Dogs: A Cadaveric Study

Lee,

Yi,

Kim

et al. 2024

Veterinary Sciences

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This study aims to evaluate the clinical application of three-dimensional (3D)-printed custom reduction guides (3DRG) for minimally invasive plate osteosynthesis (MIPO) of short oblique radial diaphyseal fractures. Canine forelimb specimens (n = 24) were prepared and a diaphyseal short oblique fracture was simulated in the distal radius and ulna. Bone fragments were stabilized with the MIPO technique using a 3DRG (Group A), open reduction (Group B), or closed reduction with circular external skeletal fixation (ESF) (Group C). The diaphyseal short oblique fractures were created in each radius at one-third of the radial length from the distal radial articular surface. Surgical stabilization of the fractures was performed in each group. Pre and postoperative radiographic images were obtained to measure frontal angulation (FA), sagittal angulation (SA), frontal joint reference line angulation (fJRLA), sagittal joint reference line angulation (sJRLA), translational malalignment and fracture gap width. Surgical time was also measured. In the homogeneity test, differences in SA, sJRLA, craniocaudal translation and fracture gap before and after surgery had no significant difference among the three groups. On the other hand, differences in FA, fJRLA, mediolateral translation and surgical time before and after surgery had significant differences among the three groups. In the post hoc test, only surgical time showed a significant difference between the three groups, and group A showed the shortest surgical time. The use of 3DRG for MIPO of short oblique radial diaphyseal fractures in dogs is reliable for the alignment and apposition of fractures and reduces surgical time.

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Section: Surgical Proceduresmentioning

confidence: 99%

Section: Surgical Proceduresmentioning

confidence: 99%

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Evaluation of a 3D-Printed Reduction Guide for Minimally Invasive Plate Osteosynthesis of Short Oblique Radial Diaphyseal Fracture in Dogs: A Cadaveric Study

Lee,

Yi,

Kim

et al. 2024

Veterinary Sciences

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“…As mentioned above, surgical fixation aims to stabilize the fracture zone, preserving an anabolic strain environment and protecting fragile granulation tissue, microvasculature, and new cartilage/bone remodeling at the site of injury [ 24 ]. Advances in minimally invasive surgical techniques and periosteal-sparing fracture fixations target the biologic factors of bone healing by preserving necessary periosteal and endosteal vascular supply, minimizing disruption to the fracture hematoma and associated signaling factors and reducing infection risk at the site of injury [ 25 , 26 ]. Research into the systemic, patient-associated factors that influence bone healing such as patient age, sex, concurrent diseases (i.e., diabetes mellitus, cardiovascular disease, etc.…”

Section: Introductionmentioning

confidence: 99%

Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review

Bowers,

Anderson

2024

Bioengineering

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Surgical management of fractures has advanced with the incorporation of advanced technology, surgical techniques, and regenerative therapies, but delayed bone healing remains a clinical challenge and the prevalence of long bone nonunion ranges from 10 to 15% of surgically managed fractures. Delayed bone healing arises from a combination of mechanical, biological, and systemic factors acting on the site of tissue remodeling, and careful consideration of each case’s injury-related, patient-dependent, surgical, and mechanical risk factors is key to successful bone union. In this review, we describe the biology and biomechanics of delayed bone healing, outline the known risk factors for nonunion development, and introduce modern preventative and corrective therapies targeting fracture nonunion.

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“…Even in its earliest stages, orthopedic plate designs reflected the challenges at hand, each aiming to improve outcome and reduce complications. Landmark achievements include the development of metallic alloys for orthopedic plates, the establishment of the Arbeitgemeinschaft fur Osteosynthesefragen (AO) principles of effective fracture treatment, the invention of compression plates to encourage primary bone healing of fractures, the refinement of plate hole designs to allow for tension or dynamic compression plating, and the establishment of minimally invasive plate osteosynthesis [1, 40, 49]. Fixed angle devices, such as point‐contact fixators and locking plates, were developed to respond to the challenges observed during conventional compression plating including marked soft tissue and periosteal damage during fixation, stress shielding of the underlying bone, and complications such as cortical porosis and/or refracture following plate removal [1, 12, 20, 29, 45].…”

Section: Introductionmentioning

confidence: 99%

Changes in tibial cortical dimensions and density associated with long‐term locking plate fixation in goats

Bowers,

Terrones,

Sun

et al. 2023

J. exp. orthop.

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Purpose Cortical porosis, secondary to either vascular injury or stress-shielding, is a comorbidity of fracture fixation using compression bone plating. Locking plate constructs have unique mechanics of load transmission and lack of reliance on contact pressures for fixation stability, so secondary cortical porosis adjacent to the plate has not been widely investigated. Therefore, this study aimed to assess the effects of long-term locking plate fixation on cortical dimensions and density in a caprine tibial segmental ostectomy model. Methods Data was acquired from a population of goats enrolled in ongoing orthopedic research which utilized locking plate fixation of 2 cm tibial diaphyseal segmental defects to evaluate bone healing over periods of 3, 6, 9, and 12 months. Quantitative data included tibial cortical width measurements and three-dimensionally reconstructed slab density measurements, both assessed using computed tomographic examinations performed at the time of plate removal. Additional surgical and demographic variables were analyzed for effect on cortical widths and density, and all cis-cortex measurements were compared to both the trans-cortex and to the contralateral limbs. Results The tibial cis-cortex was significantly wider and more irregular than the trans-cortex at the same level. This width asymmetry differed in both magnitude and direction from the contralateral limb. The bone underlying the plate was significantly less dense than the trans-cortex, and this cortical density difference was significantly greater than that of the contralateral limb. These cortical changes were independent of both duration of fixation and degree of ostectomy bone healing. Conclusions This study provides evidence that cortical bone loss consistent with cortical porosity is a comorbidity of locking plate fixation in a caprine tibial ostectomy model. Further research is necessary to identify risk factors for locking-plate-associated bone loss and to inform clinical decisions in cases necessitating long-term locking plate fixation.

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Minimally Invasive Plate Osteosynthesis

Cited by 4 publications

References 49 publications

Evaluation of a 3D-Printed Reduction Guide for Minimally Invasive Plate Osteosynthesis of Short Oblique Radial Diaphyseal Fracture in Dogs: A Cadaveric Study

Evaluation of a 3D-Printed Reduction Guide for Minimally Invasive Plate Osteosynthesis of Short Oblique Radial Diaphyseal Fracture in Dogs: A Cadaveric Study

Delayed Union and Nonunion: Current Concepts, Prevention, and Correction: A Review

Changes in tibial cortical dimensions and density associated with long‐term locking plate fixation in goats

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