Minimally invasive percutaneous medial plate‐rod osteosynthesis for treatment of humeral shaft fractures in dog and cats: Surgical technique and prospective evaluation

Abstract

Objective: To describe and prospectively report outcomes associated with a novel minimally invasive percutaneous osteosynthesis (MIPO) technique for the treatment of humeral fractures in dogs and cats. Study design: Prospective clinical case series. Animals: Eleven dogs and 4 cats with traumatic nonarticular humeral fractures. Methods: Dogs and cats that presented with traumatic humeral fractures were enrolled in the study. After closed reduction, the fracture was stabilized by using a plate-rod combination applied via remote medial incisions. Postoperative alignment in the frontal and sagittal planes was statistically compared with the contralateral limbs. Time to clinical union and complications were also recorded. Results: Eleven dogs and 4 cats were included in this study. Body weight ranged from 4.5 to 33.6 kg in dogs and from 2.2 to 3.6 kg in cats. A veterinary cuttable plate (6/11 dogs and 3/4 cats) or locking compression plate was used in a plate-rod configuration (11/11 dogs and 2/4 cats) or alone (2/4 cats). Rod-to-medullarycavity ratio was 30%. Plate-span ratio was 5.8 (range, 2-13.5). No significant differences were found in frontal or sagittal plane alignment. Healing time in cases that completed on-time follow-up (12/15) was 36 ± 14 days (range, 20-69). No major complications were recorded. Conclusion: The reported technique was associated with good outcomes in a large variety of fracture configurations and animal sizes, with no complications. Clinical significance: This report provides evidence that MIPO is a compelling alternative to open reduction and internal fixation in the treatment of various humeral fractures.

Minimally invasive percutaneous medial plate rod osteosynthesis for treatment of bicondylar humeral fractures in dogs: Surgical technique and case report

“…The dog's position and preparation were similar to those previously described for the treatment of extraarticular humeral fractures repaired using minimally invasive percutaneous plate osteosynthesis . Briefly, dogs were placed in dorsal recumbency with the thorax elevated by means of vacuum conforming bags, and table‐bound restraining devices were used to stabilize the torso.…”

“…A medial, proximal metaphyseal approach was performed as previously described . Briefly, a cutaneous incision was made over the proximal, medial humeral metaphyseal region caudal to the brachiocephalicus muscle, which was retracted cranially.…”

“…The distal approach to the medial epicondyle was then performed . With the medial epicondyle exposed, an epiperiosteal tunnel was created along the medial humeral surface.…”

“…Routine follow‐up consisted of recheck examination for suture removal at 2 weeks, followed by radiographic evaluation every 3 weeks until evidence of clinical union was documented. Objective radiographic interpretation of alignment, adjacency, apparatus, and activity/bone healing was performed as previously described . Complications were recorded and classified as minor or major, with major complications defined as those requiring surgical revision under anesthesia.…”

“…In recent years, minimally invasive osteosynthesis (MIO) has been proposed as a means to reduce complication rates associated with extensive surgical approaches and related operative trauma . Although minimally invasive osteosynthesis techniques have been described for lateral condylar humeral fracture and for extraarticular humeral fractures, successful treatment of bicondylar (T‐Y) fractures with minimally invasive osteosynthesis techniques has yet to be reported …”