Minimally invasive plate osteosynthesis of the distal femur

Abstract

Between January 2009 and November 2011, minimally invasive plate osteosynthesis using the minimally invasive cerclage passer or the collinear reduction clamp was performed in 21 patients with 23 distal femoral fractures. None of the patients suffered from postoperative malalignment or malrotation. Mean time to adequate fracture consolidation was 128 days (range 53-470 days).

Is augmented femoral lateral plating with helically shaped medial plates biomechanically advantageous over straight medial plates?

“…This was confirmed in a recently published anatomical study applying the medial 90°‐helical plate with minimally invasive plate osteosynthesis (MIPO) technique 20 . The same applies to straight lateral plates which can be safely inserted with the same technique 35 . However, inserting the additional medial straight plate with MIPO technique endangers the neurovascular structures of the thigh; therefore, 90°‐helical plates should be used as they allow for minimally invasive surgery without endangering the critical anatomical structures of the medial thigh.…”

“…20 The same applies to straight lateral plates which can be safely inserted with the same technique. 35 However, inserting the additional medial straight plate with MIPO technique endangers the neurovascular structures of the thigh; therefore, 90°-helical plates should be used as they allow for minimally invasive surgery without endangering the critical anatomical structures of the medial thigh. The downside of using 90°-helical plates is the lack of prebent implants provided by the industry and the theoretically possible weakening of the helical plate due to the bending process.…”