Minimally invasive plate osteosynthesis (MIPO) in AO/OTA type B displaced clavicle fractures

BACKGROUND: Fractures of the clavicle are one of the most common fractures in modern orthopaedics and traumatology practice. Knowing the mechanism of trauma, and it's pathophysiological elements, it's clear distinction and it's individual features are essential to the development of more new and effective methods for their treatment, and the minimising of postoperative complications.AIM: The aim of this paper was to present the results of our patients treated with minimally invasive plate osteosynthesis (MIPO).MATERIAL AND METHODS: Between January 2011 and March 2013, 12 patients were treated with MIPO technique. The mean age was 47.5 years (range, 16-79 years). Outcomes and complications of clinical treatment were reviewed.RESULTS: All fractures healed within a mean period of 4.9 months (range, 2-10 months). Regarding complications, there was no occurrence of implant failure or deep infection. There were no nonunions, but one 79-year-old man had a delayed union. Almost of all the cases didn’t need bending of the plate. Seven plates were removed by their hopes. And there weren’t any cases that required new incisions.CONCLUSIONS: A pre-contoured plate anatomically configured to fit the clavicle was easier to apply. MIPO technique for midshaft clavicle fractures may be a good option.

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Comparison between Minimally Invasive Plate Osteosynthesis and Conventional Open Plating for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/7081032 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Enzhe Zhao ◽

Rui Zhang ◽

Dou Wu ◽

Yao Guo ◽

Qiang Liu

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Cohort Studies ◽

Functional Outcome ◽

Plate Osteosynthesis ◽

Meta Analysis ◽

Operation Time ◽

Cochrane Library ◽

Minimally Invasive Plate Osteosynthesis ◽

Clavicle Fractures

Objective. The aim of this study was to compare the functional outcome and complications in midshaft clavicle fractures receiving minimally invasive plate osteosynthesis and conventional open plating. Methods. Relevant studies were searched in the databases of Medline, EMBASE, Cochrane Library, Ovid, and Web of Science from inception to March 1, 2019. Pooled data were analyzed with Cochrane Collaboration’s Review Manager 5.3. Results. A total of 7 studies were included, of which 2 were randomized controlled trials, 3 were retrospective cohort studies, and 2 were prospective cohort studies including 316 patients. No statistical differences in functional outcome (weighted mean difference [WMD] = 0.99, P=0.12), operation time (WMD = −10.44, P=0.07) and time to bone union (WMD = −0.23, P=0.70) were observed between the two groups. However, minimally invasive plate osteosynthesis reduced rates of skin numbness (odds ratio (OR) = 0.25, 95% CI : 0.13 to 0.48; P<0.0001) and complications (OR = 0.33, 95% CI : 0.16 to 0.71; P=0.005) compared with conventional open plating. Conclusion. This systematic review and meta-analysis found no differences in terms of functional outcomes, operation time, and fracture healing time between minimally invasive plate osteosynthesis and conventional open plating. However, minimally invasive plate osteosynthesis had apparent advantages in rates of skin numbness and complications.

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

MUSCULOSKELETAL SURGERY ◽

10.1007/s12306-013-0292-x ◽

2013 ◽

Vol 97 (3) ◽

pp. 229-235 ◽

Cited By ~ 8

Author(s):

C. Iacobellis ◽

C. Chemello ◽

A. Zornetta ◽

R. Aldegheri

Keyword(s):

Minimally Invasive ◽

Open Surgery ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

Type B

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Optimal plate position in minimally invasive plate osteosynthesis for mid-shaft clavicle fractures: simulation using 3D-printed models of actual clinical cases

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01330-3 ◽

2020 ◽

Author(s):

Hyun Chul Shon ◽

Jin-Young Bang ◽

Yongkoo Lee ◽

Kyoung Hwan Koh ◽

Ji Wan Kim

Keyword(s):

Minimally Invasive ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

3D Printed ◽

Clavicle Fractures ◽

Clinical Cases

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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

10.21203/rs.3.rs-40154/v1 ◽

2020 ◽

Author(s):

Cesare Marazzi ◽

Matthias Wittauer ◽

Michael T. Hirschmann ◽

Enrique A. Testa

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

Consecutive Series ◽

Type B ◽

Distal Fibula ◽

Clear Space ◽

Weber Type

Abstract BackgroundMinimally 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.MethodsA 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. ResultsThe 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.ConclusionIn 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. Trial registration:EKNZ Project-ID: 2019-02310; registrated 20th of December 2019 with swissethics

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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

10.21203/rs.3.rs-40154/v3 ◽

2020 ◽

Author(s):

Cesare Marazzi ◽

Matthias Wittauer ◽

Michael T. Hirschmann ◽

Enrique A. Testa

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

Consecutive Series ◽

Type B ◽

Distal Fibula ◽

Clear Space ◽

Weber Type

Abstract 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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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

10.21203/rs.3.rs-40154/v2 ◽

2020 ◽

Author(s):

Cesare Marazzi ◽

Matthias Wittauer ◽

Michael T. Hirschmann ◽

Enrique A. Testa

Keyword(s):

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Minimally Invasive Plate Osteosynthesis ◽

Consecutive Series ◽

Type B ◽

Distal Fibula ◽

Clear Space ◽

Weber Type

Abstract 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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