Clinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius

2015 ◽  
Vol 135 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Chun-Yu Chen ◽  
Kai-Cheng Lin ◽  
Shan-Wei Yang ◽  
Jenn-Huei Renn ◽  
Yih-Wen Tarng
Keyword(s):  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Clinical Results ◽  
Conventional Approach

Minimally Invasive Aortic Root Replacement with Valved Conduits through Partial Upper Sternotomy

2017 ◽  
Vol 66 (04) ◽  
pp. 295-300 ◽  
Author(s):  
Mosab Alshakaki ◽  
Sven Martens ◽  
Mirela Scherer ◽  
Julia Hillebrand
Keyword(s):  
Minimally Invasive ◽  
Aortic Root ◽  
Operative Procedure ◽  
Median Sternotomy ◽  
Clinical Results ◽  
Aortic Root Replacement ◽  
Conventional Approach ◽  
Surgical Access ◽  
Secondary Bleeding ◽  
Minimally Invasive Access

Background Minimally invasive surgical access through limited sternotomy reduces trauma and morbidity in cardiosurgical patients. However, until now, it is not the standard access for aortic root replacement. This study details our clinic's experience with minimally invasive implantation of valved conduits through partial upper sternotomy and the comparison to conventional full median sternotomy. Methods Between January 2012 and March 2016, a total of 187 patients underwent aortic root replacement with valved conduits in our department. Minimally invasive access through partial upper sternotomy (group A) was performed in 33 patients (9 female, 24 male; mean age: 55.68 ± 13.24 years). Four of these patients received concomitant mitral and tricuspid valve interventions. The results were compared with similar procedures through conventional approach (group B): 25 patients (7 female, 18 male; mean age: 59.09 ± 12.32 years). Results In all 33 cases of minimally invasive access and 25 cases of conventional approach, aortic root replacement was successful. Operative times were as follows (in minutes; groups A and B)—cardiopulmonary bypass: 166.12 ± 40.61 and 162.88 ± 45.89; cross-clamp time: 122.24 ± 27.42 and 113.44 ± 22.57, respectively. In both groups, two patients needed postoperative reexploration due to secondary bleeding. One multimorbid patient suffered from postoperative stroke and died on the ninth postoperative day due to heart failure. The observed operation times and clinical results after minimally invasive surgery are comparable to conduit implantation through full median sternotomy. Conclusions Partial upper sternotomy is a feasible access for safe aortic root replacement with valved conduits. Nevertheless, minimally invasive aortic root replacement is a challenging operative procedure.

scholarly journals Long Volar Plating for Metadiaphyseal Fractures of Distal Radius: Study Comparing Minimally Invasive Plate Osteosynthesis versus Conventional Approach

2017 ◽  
Vol 06 (03) ◽  
pp. 227-234 ◽  
Author(s):  
Emilie Pire ◽  
Juan Hidalgo Diaz ◽  
Santiago Salazar Botero ◽  
Sybille Facca ◽  
Philippe Liverneaux
Keyword(s):  
Minimally Invasive ◽  
Distal Radius ◽  
Plate Osteosynthesis ◽  
Conventional Approach ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Dash Score ◽  
Volar Plating ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2). In group 1, a long volar plate was inserted under pronator quadratus through a 15- to 30-mm distal incision then fixed to the epiphysis of the distal radius. Then, through a 15- to 30-mm proximal incision, the plate was fixed to the diaphysis of the radius, thus reducing the fracture. Results In group 1, mean distal incision size was 23.5 and 16.9 mm for proximal one. Mean total scar size (sum of both distal and proximal incisions) was 40.0 mm in group 1 and 84.1 mm in group 2. Mean tourniquet time was 58.4 minutes in group 1 and 68.9 minutes in group 2. At latest follow-up, no significant difference was noted in both the groups concerning pain, quick-DASH score, grip strength, ROM, and radiologic data. One extensor pollicis longus rupture treated by tendon transfer was done in group 1. Conclusion The MIPO technique for metadiaphyseal fractures of the distal radius by long volar plating has cosmetic and economic advantages compared with the conventional approach. Conversion to conventional approach is possible at any time in case of technical difficulties. Level of Evidence III.

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