Minimally invasive plate osteosynthesis in type B fibular fractures versus open surgery

Iacobellis, Claudio; Chemello, Cesare; Zornetta, A.; Aldegheri, Roberto

doi:10.1007/s12306-013-0292-x

Cited by 13 publications

(19 citation statements)

References 30 publications

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“…Even though, there were no significant difference in final outcomes between two groups. These observations go along with other researches[ 30 – 32 ]. No loosening and disruption of plates and screws occurred as LCP offered satisfactory internal fixation.…”

Section: Discussionsupporting

confidence: 91%

Callus Formation and Mineralization after Fracture with Different Fixation Techniques: Minimally Invasive Plate Osteosynthesis versus Open Reduction Internal Fixation

Xue

Ding

et al. 2015

PLoS ONE

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Minimally invasive plate osteosynthesis(MIPO) has been considered as an alternative for fracture treatment. Previous study has demonstrated that MIPO technique has the advantage of less soft tissue injury compared with open reduction internal fixation (ORIF). However, the comparison of callus formation and mineralization between two plate osteosynthesis methods remains unknown. In this experiment, ulna fracture model was established in 42 beagle dogs. The fractures underwent reduction and internal fixation with MIPO or ORIF. Sequential fluorescent labeling and radiographs were applied to determine new callus formation and mineralization in two groups after operation. At 4, 8 and 12 weeks postoperatively, the animals were selected to be sacrificed and the ulna specimens were analyzed by Micro-CT. The sections were also treated with Masson staining for histological evaluation. More callus formation was observed in MIPO group in early stage of fracture healing. The fracture union rate has no significant difference between two groups. The results indicate that excessive soft tissue stripping may impact early callus formation. As MIPO technique can effectively reduce soft tissue injury with little incision, it is considered to be a promising alternative for fracture fixation.

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Section: Discussionsupporting

confidence: 91%

Callus Formation and Mineralization after Fracture with Different Fixation Techniques: Minimally Invasive Plate Osteosynthesis versus Open Reduction Internal Fixation

Xue

Ding

et al. 2015

PLoS ONE

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“…Since the introduction of minimally invasive plate osteosynthesis (MIPO) following a biological xation principle by internal bridging of the fracture with preservation of soft tissue, this technique was successfully applied in the treatment of different long bone fractures (3,4,13,14,(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

“…In open techniques, wound complications remain among the biggest problems to overcome. Currently reported soft tissue complications range between 17,5-22% (4)(5)(6)32). In elderly patients, complication rates concerning soft tissue might rise as high as 40% (7).…”

Section: Discussionmentioning

confidence: 99%

“…Of those 20 cases, seventeen fractures healed without complications at all. (8) The only study done so far directly comparing ORIF and MIPO in the treatment of distal bula fractures was the study done by Iacobelis et al (4) They could show that none of the MIPO cases had any wound complications in comparison with 5 cases of wound complications in the ORIF group. With only 18 patients in each group this was nevertheless a rather small cohort study.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the increasing number of publications in the last ten years investigating MIPO for femoral and tibial fractures, to date there is only a paucity of studies dealing with the treatment of distal bula fractures using MIPO technique (2-4, 8, 16-18). Of those studies there is only one that directly compares MIPO to ORIF (4). Nevertheless, those studies could show a decreased risk for nonunion and infection when minimally invasive techniques where applied to treat distal bula fractures.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber type B and C fractures

Marazzi

Wittauer

Hirschmann

et al. 2020

Preprint

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Background Minimally invasive plate-osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up.Methods A consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analysed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n=35, MIPO n=35). Patients were assessed for postoperative pain using a visual analogue scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups; “no pain” for VAS=0, “low” for VAS=1-3, “moderate” for VAS=3-5 and “severe” for VAS=5-10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury as well as development of nonunion, were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap and talar tilt angle were evaluated postoperatively. Results The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p=0.029). Even though not statistically significant, specific surgery related complications such as skin necrosis (3% vs. 9%, p= 0.275), nonunion (0% vs. 6%, p=0.139), infections and wound healing disorders (9% vs. 20%, p=0.141) as well as postoperative pain (17% vs. 26%, p=0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3mm vs. 2.7mm, p=0.033). The talocrural angle, talar tilt angle, lateral and medial clear space showed to be equivalent in both groups.Conclusion In this retrospective single-center consecutive series MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate.

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A short single-incision approach for antiglide plate fixation of oblique fractures of the lateral malleolus: a technical tip

Bitar

Nishikawa

Godoy‐Santos

et al. 2020

Eur J Orthop Surg Traumatol

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Minimally invasive plate osteosynthesis in type B fibular fractures versus open surgery

Cited by 13 publications

References 30 publications

Callus Formation and Mineralization after Fracture with Different Fixation Techniques: Minimally Invasive Plate Osteosynthesis versus Open Reduction Internal Fixation

Callus Formation and Mineralization after Fracture with Different Fixation Techniques: Minimally Invasive Plate Osteosynthesis versus Open Reduction Internal Fixation

Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber type B and C fractures

A short single-incision approach for antiglide plate fixation of oblique fractures of the lateral malleolus: a technical tip

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