The Internal Fixator Principle Applied to Proximal Tibial Fractures - An Early Gait Analysis Study

2013 ◽  
Vol 430 ◽  
pp. 213-216
Author(s):  
Dan Crisan ◽  
Dan Ioan Stoia ◽  
Radu Prejbeanu ◽  
Dinu Vermeşan ◽  
Horia Hărăgus
Keyword(s):  
Minimally Invasive ◽  
Gait Analysis ◽  
Movement Analysis ◽  
Ct Scanning ◽  
Clinical Results ◽  
Minimally Invasive Technique ◽  
Internal Fixator ◽  
Invasive Technique ◽  
Invasive Approach ◽  
Significant Difference

The internal fixator principle is a novel, minimally invasive approach to epiphyseal fractures of the long bones. It has been advocated to provide a stable fixation of fracture fragments with the preservation of the osseous blood supply due to the lack of periosteal decortication. The aim of this minimally invasive technique is to allow for early rehabilitation, so in theory patients that went trough minimally invasive internal fixation osteosynthesis should have better clinical results with higher scores than patients that had classic ORIF technique. We investigated a number of 18 tibial plateau fractures in 18 patients that were matched by fracture classification and patient sex and age, 9 were treated by conventional plating techniques and the other 9 were treated by using an internal fixator. The patients were evaluated pre and postoperatively by conventional radiographic means and by CT scanning with 3D reconstruction, they were evaluated with the KOOS score at 3 and 6 months postoperative. Gait analysis was performed in the lab using a Zebris FDM System and a Zebris CMS 10 3D Movement Analysis System. Gait analysis was performed based on patient availability as soon as ambulation was possible and permitted without auxiliary support (crutches). KOOS scores increased from 3 to 6 months, the initial evaluation showed a mean value of 27,5 (19,7 to 39,4) for the ORIF group and a value of 33,9 (24,1 to 42,4) for the internal fixator group at 3 months, and increased to 64,8 (55,3 to 73,1) for the ORIF group and 69,8 (59,7 to 82,7) for the internal fixator group. The difference between stance and swing times, knee flexion angles and was found not to be statistically significant (p<0.05) at either 3 or 6 months postoperatively. The data shows no clear advantage in using an internal fixator over the classic plating methods at 6 months postoperatively. The minimally invasive technique provided for faster wound healing with better KOOS scores at 3 months but there was no statistically significant difference at 6 months postoperative. Limitations of the current study are the relatively small number of matched patients and the heterogeneity in patient physical characteristics such as patient weight and height and the level of preoperative fitness.

scholarly journals Minimally Invasive Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy

2017 ◽  
Vol 12 (6) ◽  
pp. 489-492 ◽  
Author(s):  
Farah N. Musharbash ◽  
Matthew R. Schill ◽  
Matthew C. Henn ◽  
Ralph J. Damiano
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Septal Myectomy ◽  
Patient Preparation ◽  
Clinical Considerations

Surgical septal myectomy is the treatment of choice for patients with symptomatic hypertrophic obstructive cardiomyopathy refractory to medications. This report describes our minimally invasive approach for performing a septal myectomy via a ministernotomy that has been used at our institution for more than a decade. In particular, patient preparation, surgical technique, and clinical considerations are highlighted. Performed properly, this minimally invasive technique is a feasible and effective approach in our experience.

Stabilization of a Type B1.1 Injury in a Morbidly Obese Patient Using an Internal Fixator in a Minimally Invasive Technique

2019 ◽  
Vol 9 (3) ◽  
pp. e0075-e0075 ◽  
Author(s):  
Tobias Fritz ◽  
Benedikt J. Braun ◽  
Nils T. Veith ◽  
Sascha J. Hopp ◽  
Laura Mettelsiefen ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Obese Patient ◽  
Minimally Invasive Technique ◽  
Internal Fixator ◽  
Invasive Technique ◽  
Morbidly Obese ◽  
Morbidly Obese Patient

scholarly journals The Mini-Open transpedicular thoracic discectomy: surgical technique and assessment

2008 ◽  
Vol 25 (2) ◽  
pp. E5 ◽  
Author(s):  
John H. Chi ◽  
Sanjay S. Dhall ◽  
Adam S. Kanter ◽  
Praveen V. Mummaneni
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Disc Space ◽  
Disc Herniations ◽  
Thoracic Disc ◽  
Mini Open

Object Thoracic disc herniations can be surgically treated with a number of different techniques and approaches. However, surgical outcomes comparing the various techniques are rarely reported in the literature. The authors describe a minimally invasive technique to approach thoracic disc herniations via a transpedicular route with the use of tubular retractors and microscope visualization. This technique provides a safe method to identify the thoracic disc space and perform a decompression with minimal paraspinal soft tissue disruption. The authors compare the results of this approach with clinical results after open transpedicular discectomy. Methods The authors performed a retrospective cohort study comparing results in 11 patients with symptomatic thoracic disc herniations treated with either open posterolateral (4 patients) or mini-open transpedicular discectomy (7 patients). Hospital stay, blood loss, modified Prolo score, and Frankel score were used as outcome variables. Results Patients who underwent mini-open transpedicular discectomy had less blood loss and showed greater improvement in modified Prolo scores (p = 0.024 and p = 0.05, respectively) than those who underwent open transpedicular discectomy at the time of early follow-up within 1 year of surgery. However, at an average of 18 months of follow-up, the Prolo score difference between the 2 surgical groups was not statistically significant. There were no major or minor surgical complications in the patients who received the minimally invasive technique. Conclusions The mini-open transpedicular discectomy for thoracic disc herniations results in better modified Prolo scores at early postoperative intervals and less blood loss during surgery than open posterolateral discectomy. The authors' technique is described in detail and an intraoperative video is provided.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Motohide Shibayama ◽  
Guang Hua Li ◽  
Li Guo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

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