scholarly journals A Comparative Study of Intramedullary Nailing and Minimally Invasive Percutaneous Plate Osteosynthesis for Type A Tibial Fracture Healing

2020 ◽  
Vol 2 (3) ◽  
pp. 14-19
Author(s):  
Jianjun Huang ◽  
Songsen Su ◽  
Yongqing Liu ◽  
Haibin Yu
Keyword(s):  
Minimally Invasive ◽  
Fracture Healing ◽  
Intramedullary Nailing ◽  
Tibial Fracture ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Operation Time ◽  
Type A ◽  
Healing Time ◽  
Formation Time

Objective This study aimed to retrospectively compare the efficacy of intramedullary nailing and minimally invasive percutaneous plate osteosynthesis (MIPPO) on the fracture healing of patients with type A tibial fractures. Methods Patients who had been diagnosed with type A tibial fracture (AO classification method) and treated with minimally invasive surgery in our hospital from January 2016 to January 2019 were included in the study. There were 21 patients in the MIPPO group and 27 patients in the intramedullary nailing group. The operation time, intraoperative blood loss, surgical incision length, callus formation time, and fracture healing time of the two groups were analyzed and compared. Results In the intramedullary nailing group, the callus formation time and the fracture healing time were shorter than those in the MIPPO group (P<0.005). Their operation time, intraoperative blood loss, and the surgical incision length were comparable between the two groups. Conclusions For patients with type A tibial fracture and poor wound tissue conditions, intramedullary nailing fixation treatment may be a better choice than MIPPO. Because in patients receiving intramedullary nailing treatment, the callus formation time and fracture healing time are short, and functional exercises can be performed soon after the surgery, which can reduce the occurrence of related complications.

Operative Management of Distal Tibial Extra-articular Fractures – Intramedullary Nail Versus Minimally Invasive Percutaneous Plate Osteosynthesis

2017 ◽  
Vol 19 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Iftikhar H. Wani ◽  
Naseem ul Gani ◽  
Mohammad Yaseen ◽  
Adil Bashir ◽  
Mohammad Shahid Bhat ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Intramedullary Nailing ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Controlled Study ◽  
Articular Fractures ◽  
Foot Function Index ◽  
Function Index ◽  
Foot Function ◽  
One Year

Background. The ideal treatment of distal tibial extra articular fractures remains controversial. Minimally invasive percutaneous plate osteosynthesis and intramedullary nailing are the two most commonly used methods. We did a prospective randomized controlled study to assess the functional outcome of distal tibial extra articular tibial fractures by comparing these treatment methods. Materials and methods. Sixty patients with distal tibial extra articular fractures were randomly assigned to an IMN (intramedullary nailing) group and a MIPPO (minimally invasive percutaneous plate osteosynthesis) group. All patients were followed up for a period of one year. At final follow-up, clinical and radiological outcome was assessed by foot function index. Malunion, infection, implant removal, time to union and secondary interventions were compared between the two groups. The comparison of continuous variables was performed by using the Student t-test or Mann-Whitney U test in accordance with normality testing. A value of p less than 0.05 was considered statistically significant. Results. All patients were followed up for a period of one year. Time to callus formation was equal in both groups. There was no non-union in our series. Malunion was more common in the nailing group. The foot function index was similar in both groups. Conclusion. MIPPO and intramedullary nailing are effective treatment options in the management of distal tibial extra particular fractures, with comparable functional outcomes.

scholarly journals Treatment of humeral shaft fractures: a new minimally-invasive plate osteosynthesis versus open reduction and internal fixation: a case control study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Yang ◽  
Dapeng Liu ◽  
Lina Zhang ◽  
Zhanxin Lu ◽  
Tang Liu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Fracture Healing ◽  
Plate Osteosynthesis ◽  
Constant Score ◽  
Healing Time ◽  
Humeral Shaft ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Humeral Shaft Fractures ◽  
Shaft Fractures ◽  
Intraoperative Fluoroscopy

Abstract Background To evaluate the feasibility and safety of a new minimally-invasive surgical approach–anteromedial minimally-invasive plate osteosynthesis (MIPO)–in the treatment of middle and distal humeral shaft fractures. Methods Fourteen patients with humeral shaft fracture treated with anteromedial MIPO from November 2016 to March 2020 (MIPO Group) were selected as the study subjects. Open reduction and internal fixation (ORIF) were used to treat 14 patients with humeral shaft fractures as the control group (ORIF group). The two groups were fixed with a locking compression plate (LCP) or LCP + multi-directional locking screw system (MDLS). The incision length, intraoperative blood loss, intraoperative fluoroscopy time, operation time, length of hospital stay, fracture healing time, QuickDASH score and Constant score were observed and compared between the two groups. Results Fourteen patients were enrolled in each group. The incision length (7.79 ± 2.39 cm), intraoperative blood loss (96.07 ± 14.96 mL), operative time (110.57 ± 21.90 min), hospital stay (6.29 ± 1.49 days) and fracture healing time (14.94 ± 0.99 weeks) in the MIPO group were all lower than those in the ORIF group, and the difference was statistically significant for each parameter (P < 0.05). The intraoperative fluoroscopy time (20.07 ± 3.22) in the MIPO group was significantly higher than that in the ORIF group (P < 0.05). There were no significant differences in age (P = 0.078), QuickDASH score (P = 0.074) or Constant score (P = 0.293) between the two groups and no postoperative complications occurred in any of the patients. Conclusion The anteromedial approach MIPO technique has the advantages of less trauma, less bleeding, low risk of nerve injury and high rate of fracture healing. It is one of the most effective methods for the treatment of middle and middle–distal humeral shaft fractures.

scholarly journals Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?

Biomedicines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 691
Author(s):  
Jan Barcik ◽  
Devakara R. Epari
Keyword(s):  
Fracture Healing ◽  
Bone Healing ◽  
Mechanical Stimulation ◽  
Callus Formation ◽  
Weight Bearing ◽  
Healing Process ◽  
Healing Time ◽  
Mechanical Environment ◽  
Clinically Significant ◽  
The Impact

The impact of the local mechanical environment in the fracture gap on the bone healing process has been extensively investigated. Whilst it is widely accepted that mechanical stimulation is integral to callus formation and secondary bone healing, treatment strategies that aim to harness that potential are rare. In fact, the current clinical practice with an initially partial or non-weight-bearing approach appears to contradict the findings from animal experiments that early mechanical stimulation is critical. Therefore, we posed the question as to whether optimizing the mechanical environment over the course of healing can deliver a clinically significant reduction in fracture healing time. In reviewing the evidence from pre-clinical studies that investigate the influence of mechanics on bone healing, we formulate a hypothesis for the stimulation protocol which has the potential to shorten healing time. The protocol involves confining stimulation predominantly to the proliferative phase of healing and including adequate rest periods between applications of stimulation.

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

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
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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