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DOI: 10.3415/VCOT-11-07-0097
Retrospective comparison between minimally invasive plate osteosynthesis and open plating for tibial fractures in dogs
Publication History
Received
14 July 2011
Accepted
10 May 2012
Publication Date:
18 December 2017 (online)
Summary
Objectives: To compare fracture healing in diaphyseal tibial fractures stabilized using either minimally invasive plate osteosynthesis (MIPO) or open reduction and internal fixation (ORIF).
Methods: Dogs in each group were matched for type of fracture, age and body weight. Stage of healing was measured blindly every four weeks postoperatively until complete healing. Outcome variables including fracture length, plate length, plate bridging ratio, plate working length, healing grading, and fracture reduction were compared between groups using the Mann-Whitney test. Significant difference was set at p <0.05.
Results: Based on the definition of clinical union, at 30 days five out of eight dogs managed with MIPO had healed, while two of the eight of dogs managed with ORIF had healed. We did not find any significant differences in the other outcome measures. No complications were reported in the MIPO group whereas one major complication was reported in the ORIF group.
Clinical significance: All dogs treated by MIPO healed rapidly without any complications, nevertheless the difference in radiographic healing between the two groups was not significant.
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References
- 1 Krettek C, Muller M, Miclau T. Evolution of minimally invasive plate osteosynthesis (MIPO) in the femur. Injury 2001; 32: 14-23.
- 2 Farouk O, Krettek C, Miclau T. et al. Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique. J Orthop Trauma 1999; 13: 401-406.
- 3 Johnson AL. Current concepts in fracture reduction. Vet Comp Orthop Traumatol 2003; 16: 59-66.
- 4 Leunig M, Hertel R, Siebenrock KA. et al. The evolution of indirect reduction techniques for the treatment of fractures. Clin Orthop Relat Res 2000; 375: 7-14.
- 5 Rovesti GL, Margini A, Cappellari F. et al. Clinical application of intraoperative skeletal traction in the dog. Vet Comp Orthop Traumatol 2006; 19: 14-19.
- 6 Schmokel H, Hurter K, Schawalder P. Percutaneous plating of tibial fractures in two dogs. Vet Comp Orthop Traumatol 2003; 16: 191-195.
- 7 Schmokel HG, Stein S, Radke H. et al. Treatment of tibial fractures with plates using minimally invasive percutaneous osteosynthesis in dogs and cats. J Small Anim Pract 2007; 48: 157-160.
- 8 Hudson C, Pozzi A, Lewis DD. Introduction to minimally invasive plating osteosynthesis in dogs. Vet Comp Orthop Traumatol 2009; 22: 175-182.
- 9 Pozzi A, Lewis DD. Surgical approaches for minimally invasive plating osteosynthesis in dogs. Vet Comp Orthop Traumatol 2009; 22: 316-320.
- 10 Dejardin LM, Cabassu JP. Femoral fractures in young dogs. AO Dialogue 2008; 3: 39-43.
- 11 Haaland PJ, Sjöström L, Devor M. et al. Appendicular fracture repair in dogs using the locking compression plate system: 47 cases. Vet Comp Orthop Traumatol 2009; 22: 309-315.
- 12 Witsberger TH, Hulse DA, Kerwin SC. et al. Minimally invasive application of a radial plate following placement of an ulnar rod in treating antebrachial fractures. Vet Comp Orthop Traumatol 2010; 6: 459-467.
- 13 Guiot LP, Dejardin LM. Prospective evaluation of minimally invasive plate osteosynthesis in 36 nonarticular tibial fractures in dogs and cats. Vet Surg 2011; 40: 171-182.
- 14 Pozzi A, Risselada M, Winter MD. Ultrasonographic and radiographic assessment of fracture healing after minimally invasive plate osteosynthesis and open reduction and internal fixation of radius-ulna fractures in dogs. J Am Vet Med Assoc. 2012 in press.
- 15 Montavon P, Unger PM, Heim UFA. Classification of fractures of long bone in dogs and cats: introduction and clinical application. Vet Comp Orthop Traumatol 1990; 3: 41-50.
- 16 Piermattei DL, Flo G, DeCamp C. Handbook of Small Animal Orthopedics and Fracture Repair Fourth Edition. Philadelphia: W.B. Sauders Company; 2006. pg. 25-159
- 17 Schwarz G. Fracture of the tibial diaphysis. In: Johnson AL, Houlton JEF, Vannini R. editors. AO Principles of Fracture Management in the Dog and Cat. Stuttgart: AO Publishing / Georg Thieme Verlag; 2005. pg. 337-350
- 18 Piermattei DL. Approach to the tibial diaphysis. In: An atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Philadelphia: W.B. Sauders Company; 1993. pg. 298-301.
- 19 Dismukes DI, Tomlinson JL, Fox DB. et al. Radiographic measurement of the proximal and distal mechanical joint angles in the canine tibia. Vet Surg 2007; 36: 699-704.
- 20 Anderson GM, Lewis DD, Radasch RM. et al. Circular external skeletal fixation stabilization of antebrachial and crural fractures in 25 dogs. J Am Anim Hosp Assoc 2002; 39: 479-498.
- 21 Miller DL, Goswami T. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing. Clin Biomech 2007; 22: 1049-1062.
- 22 Hammer RRR, Hammerby S, Lindholm B. Accuracy of radiologic assessment of tibial shaft fracture union in humans. Clin Orthop 1985; 199: 233-238.
- 23 Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analyses. J Bone Joint Surg (Am) 1976; 58: 453-458.
- 24 Cheng W, Li Y, Manyi W. Comparison study of two surgical options for distal tibia fracture—minimally invasive plate osteosynthesis vs. open reduction and internal fixation. Internat Orthop 2010; 35: 737-742.
- 25 Kreder HJ, Hanel DP, McKee J AM. et al. Indirect reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular fractures of the distal radius: a randomized controlled trial. J Bone Joint Surg (Br) 2005; 87-B: 829-836.
- 26 Petazzoni M, Urizzi A, Verdonck B. et al. Fixin internal fixator. Concept and technique. Vet Comp Orthop Traumatol 2010; 23: 250-253.
- 27 Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury 2003; 34: 63-76.