Minimally invasive plating in lower limb fractures

Authors

Keywords:

osteosynthesis, minimally invasive plaque, bone, fracture, consolidation.

Abstract

Introduction: The minimally invasive plate technique in the treatment of long bone fractures should be reproduced due to its biological advantages, as the preservation of the ideal environment of the fracture for consolidation and the reduction of the risks of deep infection and non-union.

Objective: To evaluate the results of the minimally invasive plate technique in fractures of the lower limb.

Methods: A prospective intervention study with level of evidence type 4 and grade C was carried out to determine the results of this minimally invasive procedure in patients treated from January 2019 to December 2021 at Mario Muñoz Monroy Military Hospital in Matanzas.

Results: Out of the 28 patients studied, twenty were male and eight were female. Dynamic compression plates were used in 23 cases of femur, tibia, and ankle shaft fractures, and five used 1/3 shank plates for distal fibula fractures. Ten patients had a multifragmentary stroke. Using the Arbeitsgemeinschaftfür Osteosynthesefragen (AO) classification, the different fracture types were characterized.

Conclusions: In accordance with Theodore Miclau's considerations, all 28 patients achieved fracture consolidation, clinically and radiologically, through minimally invasive plate osteosynthesis.

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Author Biographies

Alejandro Celza Mena, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista Primer Grado de Ortopedia y Traumatología

Alberto Delgado Quiñones, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista 2do Grado de Ortopedia y Traumatología.

Enrique Armando Pancorbo Sandoval, Universidad de Ciencias Medicas de Matanzas Hospital Militar Dr. Mario Muñoz Monroy. Matanzas

Jefe Servicio de Ortopedia Hospital Militar, Presidente Capítulo de Matanzas. Vicetesorero de la Junta Nacional de Ortopedia de Cuba.

Dunieski Hernández Valera, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista 2do Grado de Ortopedia y Traumatología.

Giraldo Díaz Prieto, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista Primer Grado de Ortopedia y Traumatología.

Ronald E. Cruz Alard, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista Primer Grado de Ortopedia y Traumatología.

Ricardo Hernández Yagudin, Hospital Militar Dr. Mario Muñoz Monroy Orden Carlos J. Finlay

Especialista Primer Grado de Ortopedia y Traumatología

References

Ceballos A, Tabares H, Balmaseda R, Álvarez O, Rivero J. Evolución histórica de la osteosíntesis de huesos largos I: Fijación con placa y tornillos. Rev Cub Ortop Traumatol. 2021 [acceso 17/08/2022];35(1):e395. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2021000100015

Giannoudis PV, Thomas A. Einhorn TA and Marsh D. Fracture healing: A harmony of optimal biology and optimal fixation? Injury. 2007;38(supl 4):S1-2. DOI: https://doi.org/10.1016/s0020-1383(08)70002-0

Andrzejowski P, Giannoudis PV. The ‘diamond concept’ for long bone non-union management. J Orthop Traumatol. 2019;20:21. DOI: https://doi.org/10.1186/s10195-019-0528-0

Perren SM. Evolution of the internal fixation of long bone fractures the scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br. 2002;84-B(8):1093-110. DOI: https://doi.org/10.1302/0301-620x.84b8.13752

Epari DR, Gurung R, Hofmann-Fliri L, Schwyn R, Schuetz M, Windolf M. Biphasic plating improves the mechanical performance of locked plating for distal femur fractures. J Biomech. 2021;115:110192. DOI: https://doi.org/10.1016/j.jbiomech.2020.110192

Augat P, von Rüden C. Evolution of fracture treatment with bone plates. Injury. 2018;49(supl 1):S2-7. DOI: https://doi.org/10.1016/s0020-1383(18)30294-8

Fenandez L, García O, Martín R, García O. Osteosíntesis mínima invasiva percutánea con placa en fractura de tibia distal. Rev Cub Ortop Traumatol. 2021 [acceso 30/08/2023];35(1). Disponible en: https://revortopedia.sld.cu/index.php/revortopedia/article/view/353

Ruchelli LS, Allende CA, Gutiérrez N, Capomassi MA, Gardenal MR. Osteosíntesis percutánea mínimamente invasiva lateral en fracturas de húmero. Rev Asoc Argent Ortop Traumatol. 2016 [acceso 30/08/2022];81(3):213-8. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1852-74342016000300008

Mifsut D, Zurriaga J, Catalá R, Gomar F. Osteosíntesis mínimamente invasiva con placa en fracturas de radio distal tipo C. Rev Esp Cir Osteoart. 2016 [acceso 16/07/2023];51(265):16-22. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=5475370

Varkey B. Principles of clinical ethics and their application to practice. Med Princ Pract. 2021;30(1):17-28. DOI: https://doi.org/10.1159/000509119

Alomar AZ. Nivel de confianza, desafíos y obstáculos que enfrentan los residentes ortopédicos para obtener el consentimiento informado. J Orthop Surg Res. 2021;16:390. DOI: https://doi.org/10.1186/s13018-021-02531-1

Pineda L, González A, Fernández LA. La atención médica y legal en la especialidad de Ortopedia y Traumatología. Rev Cub Ortop Traumatol. 2021 [acceso 26/10/2022];35(1):e374. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-215X2021000100016&lng=es

Morshed S, Corrales L, Genant H, Miclau III T. Outcome assessment in clinical trials of fracture-healing. J Bone Joint Surg Am. 2008;90(supl 1):62-7. DOI: https://doi.org/10.2106/jbjs.g.01556

Brito M. Fracturas diafisiarias de tibia tratadas con placa lateral por técnica mínimamente invasiva. Rev Venez Cir Ortop Traumatol. 2021 [acceso 26/04/2023];53(1):27-34. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1252908

Yañez JM. Minimally invasive treatment of AO B ankle fractures: Surgical technique and long-term outcomes. Foot Ankle Surg. 2021;27(7):742-9. DOI: https://doi.org/10.1016/j.fas.2020.09.010

Illur V, Shivgonda R, Shah J, Chaudhary N, Vijaysinh Bhosale V. Functional outcome of distal tibia fracture treated with locking compression plate using minimally invasive percutaneous plate osteosynthesis technique (MIPPO): A prospective study. Int J Orthop Sci. 2019;5(4):980-4. DOI: https://doi.org/10.22271/ortho.2019.v5.i4q.1803

Kang H, Rho JY, Song J-K, Choi J, suk Kwona Y, Choi S. Comparison between intramedullary nailing and minimally invasive plate osteosynthesis for tibial shaft fractures. Injury. 2021;52(4):1011-6. DOI: https://doi.org/10.1016/j.injury.2021.01.038

Sourougeon Y, Barzilai Y, Haba Y, Barak B, Prat D. Outcomes following minimally invasive plate osteosynthesis (MIPO) application in tibial pilon fractures – A systematic review. Foot Ankle Surg. 2023;29(8):566-75. DOI: https://doi.org/10.1016/j.fas.2023.07.013

Vidović D, Matejčić A, Ivica M, Jurišić D, Elabjer E, Bakota B. Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications. Injury. 2015;46(supl 6): S96-9. DOI: https://doi.org/10.1016/j.injury.2015.10.067

Decruz J, Antony RP, Khan SA. Epidemiology of inpatient tibia fractures in Singapore - A single centre experience. Chin J Traumatol. 2019;22(2):99-102. DOI: https://doi.org/10.1016/j.cjtee.2019.01.004

Hohenberger GM, Schwarz AM, Grechenig P, Clement B, Staresinic M, Bakota B. Medial minimally invasive helical plate osteosynthesis of the distal femur - a new technique. Injury. 2021;52(supl 5):S27-31. DOI: https://doi.org/10.1016/j.injury.2020.02.051

Neumann MV, Sontheimer V, Borchert GH, Izadpanah K, Hagen Schmal L, Kubosch EJ. Outcome evaluation of distal femoral fractures following surgical management: a retrospective cohort study. J Pers Med. 2023;13(2):350. DOI: https://doi.org/10.3390/jpm13020350

Fernández E, Herrera M, Vilá J. Fracturas de maléolo posterior: indicaciones de fijación y vías de abordaje. Rev Esp Cir Ortop Traumatol. 2023;67(2):160-9. DOI: https://doi.org/10.1016/j.recot.2022.10.019

Yañez J, Arzac IR, Fiorentini G, Yañez M. Fracturas de tobillo: Comparación entre la cirugía abierta y el método mínimamente invasivo. Rev Asoc Argent Ortop Traumatol. 2016 [acceso 26/10/2023];81(1):27-34. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-835441

Alvarez A, Valdebenito V, Soto SR. Sindesmosis tibioperonea: diagnóstico, métodos de fijación y artroscopia. Rev Inf Cient. 2023;102:4087. DOI: https://doi.org/10.5281/zenodo.7768163

Wu HJ, He YX, Hang C, Hao L, Lin TK. AO distractor and manual traction reduction techniques repair in distal tibial fractures: a comparative study. BMC Musculosk Dis. 2022;23:1081. DOI: https://doi.org/10.1186/s12891-022-06008-y

Paulsson M, Ekholm C, Tranberg R, Rolfson O, Geijer M. Using a traction table for fracture reduction during minimally invasive plate osteosynthesis (MIPO) of distal femoral fractures provides anatomical alignment. JJ Clin Med. 2023;12(12):4044. DOI: https://doi.org/10.3390/jcm12124044

Singh J, Aggarwal R, Jasrotia C, Dewan A. Functional outcome of MIPO (Minimally Invasive Plate Osteosynthesis) in distal third femur fractures with intra articular extension. J Orthop Sports Med. 2023;5(1):67-71. DOI: http://dx.doi.org/10.26502/josm.511500081

Shon OJ, Jae S, Beom G. Long locking plate combined with locking attachment plate in patients with periprosthetic femoral fracture around ipsilateral stem after total knee arthroplasty. BMC Musculosk Dis. 2023;24:594 DOI: https://doi.org/10.1186/s12891-023-06726-x

Galal S. Minimally invasive plate osteosynthesis has equal safety to reamed intramedullary nails in treating Gustilo-Anderson type I, II and III-A open tibial shaft fractures. Injury. 2018;49(4):866-70. DOI: https://doi.org/10.1016/j.injury.2018.03.008

Marazzi C, Wittauer M, Hirschmann MT, Testa EA. Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber types B and C fractures. J Orthop Surg Res. 2020;15(1):491. DOI: https://doi.org/10.1186/s13018-020-02018-5

van de Wall BJM, Beeres FJP, Knobe M, Link BC, Babst R. Minimally invasive plate osteosynthesis: An update of practice. Injury. 2021;52(1):37-42. DOI: https://doi.org/10.1016/j.injury.2020.11.003

Published

2024-05-19

How to Cite

1.
Celza Mena A, Delgado Quiñones A, Pancorbo Sandoval EA, Hernández Valera D, Díaz Prieto G, Cruz Alard RE, et al. Minimally invasive plating in lower limb fractures. Revista Cubana de Ortopedia y Traumatologí­a [Internet]. 2024 May 19 [cited 2025 Mar. 9];38. Available from: https://revortopedia.sld.cu/index.php/revortopedia/article/view/826

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