Minimally Invasive Fracture Repair
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Preface Minimally Invasive Fracture Repair Brian S. Beale, DVM Antonio Pozzi, DMV, MS Guest Editors Fracture stabilization techniques continue to evolve and to provide approaches that minimize iatrogenic trauma associated with surgery. This issue includes a comprehen- sive look at the current status of treatment of fractures using minimally invasive plate osteosynthesis (MIPO) and minimally invasive surgery. Principles of minimally invasive fracture repair are included as well as case examples of different fracture types of all the major long bones. The editors sincerely appreciate the efforts of the individual article authors as much time and effort were put forth to bring together an issue that provides a clear view of the principles and clinical recommendations needed to help surgeons develop the skills to successfully manage simple and comminuted fractures in dogs and cats using minimally invasive fracture repair. The concept of biological internal fixation has been predicated for years with the goal of maximizing preservation of the blood supply to the fractured bone. This trend resulted in new implants and new techniques that allowed surgeons to approach fracture fixation with smaller, less invasive approaches. The principal concept is to gain access to the bone via small incisions away from the fracture zone, thus preserving blood supply to the fracture fragments. The small incisions provide a means of inserting a bone plate and placing screws to achieve stabilization and osteosynthesis. In this issue we included a description of the techniques of indirect reduction as well as fracture fixation using minimally invasive techniques. The logical evolution of biologic fracture fixation has been minimally invasive frac- ture fixation. Although young surgeons consider minimally invasive fracture fixation a novel approach, history would prove them wrong, as percutaneous nailing was already performed by Kuntscher in the 1940s. However, the technique was not readily used until the 1990s. So, what is really new about minimally invasive fracture fixation? The answer is probably technology. Improvements in fixation implants and imaging techniques allow the surgeon to achieve more consistent results with fewer complica- tions. Advanced imaging techniques such as fluoroscopy and arthroscopy allow a method of guiding the reduction of the fracture and the application of the implants. New implants such as locking plates facilitate reduction and fixation of fractures, while Vet Clin Small Anim 42 (2012) xi–xii http://dx.doi.org/10.1016/j.cvsm.2012.08.007 vetsmall.theclinics.com 0195-5616/12/$ – see front matter Ó 2012 Elsevier Inc. All rights reserved. Minimally Invasive Fracture Repair
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Transcript of Minimally Invasive Fracture Repair
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Preface
ovide a means of inserting a bone plateo osteosynthesis. In this issuewe includedt uction as well as fracture fixation usingcti ation has been minimally invasive frac-g ider minimally invasive fracture fixationh wrong, as percutaneous nailing wasy However, the technique was not readily. out minimally invasive fracture fixation?a ments in fixation implants and imaging
consistent results with fewer complica-a as fluoroscopy and arthroscopy allow
Minimally Invasive Fracture RepairVet Clin Small Anim 42 (2012) xixii
vetsmall.theclinics.comhttp://dx.doi.org/10.1016/j.cvsm.2012.08.007a method of guiding the reduction of the fracture and the application of the implants.New implants such as locking plates facilitate reduction and fixation of fractures, whileandplacing screws ta description of theminimally invasive te
The logical evoluture fixation. Althoua novel approach,already performed bused until the 1990sThe answer is probtechniques allow thetions. Advanced im0195-5616/12/$ see frachievestabilization andechniques of indirect redhniques.on of biologic fracture fixh young surgeons consistory would prove themKuntscher in the 1940s.So, what is really new abbly technology. Improvesurgeon to achieve moreging techniques suchthe fracture fragments. The small incisions prMinimally Invasive Fracture Repair
Brian S. Beale, DVM Antonio Pozzi, DMV, MS
Guest Editors
Fracture stabilization techniques continue to evolve and to provide approaches thatminimize iatrogenic trauma associated with surgery. This issue includes a comprehen-sive look at the current status of treatment of fractures using minimally invasive plateosteosynthesis (MIPO) and minimally invasive surgery. Principles of minimally invasivefracture repair are included as well as case examples of different fracture types of allthe major long bones. The editors sincerely appreciate the efforts of the individualarticle authors as much time and effort were put forth to bring together an issue thatprovides a clear view of the principles and clinical recommendations needed to helpsurgeons develop the skills to successfully manage simple and comminuted fracturesin dogs and cats using minimally invasive fracture repair.
The concept of biological internal fixation has been predicated for yearswith the goalofmaximizing preservation of the blood supply to the fracturedbone. This trend resultedin new implants and new techniques that allowed surgeons to approach fracture fixationwith smaller, less invasive approaches. The principal concept is to gain access to thebone via small incisions away from the fracture zone, thus preserving blood supply toont matter 2012 Elsevier Inc. All rights reserved.
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keeping a balance between biomechanics and biology. While bone plates are usedmost commonly for minimally invasive fracture repair, other implant systems suchas the interlocking nail and external fixator can be used with success too.
An obvious question arises: is minimally invasive fracture fixation better than openreduction and fracture fixation? A reasonable answer would be that it depends on thefracture type. The benefits of a minimally invasive approach may be more evident forspecific types of fractures. However, this question can only be answered with well-de-signed future prospective studies. Early studies suggest fracture repair using theMIPO technique benefits the patient by providing less morbidity and accelerated frac-ture healing. With this issue our intention is to present an up-to-date description of thetechniques of minimally invasive fracture fixation used in small animals. We hope thatthis issue will trigger interest andmotivate more surgeons to use these new techniquesand help spawn future techniques that will continue to improve our outcome with mini-mally invasive fracture repair.
Brian S. Beale, DVMGulf Coast Veterinary Specialists
1111 West Loop South #160Houston, TX 77027, USA
Antonio Pozzi, DMV, MS
PrefacexiiCollege of Veterinary MedicineUniversity of Florida
2015 SW 16th AvenuePO Box 100126
Gainesville, FL 32610-0126, USA
E-mail addresses:[email protected] (B.S. Beale)
[email protected] (A. Pozzi)
Minimally Invasive Fracture Repair
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