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Minimally Invasive Plate Osteosynthesis Using Fracture Reduction Under the Plate without Intraoperative Fluoroscopy to Stabilize Diaphyseal Fractures of the Tibia and Femur in Dogs and Cats
01 May 2018
28 May 2019
29 July 2019 (online)
Objective The aim of this study was to prospectively evaluate postoperative alignment when using fracture reduction under the plate (FRUP) during a minimally invasive plate osteosynthesis in tibial and femoral fractures, without intraoperative imaging, and report immediate postoperative complications.
Materials and Methods After precise plate contouring and preoperative planning, FRUP was obtained with one cortical screw per fragment. Fractures were stabilized with a plate or plate rod. Tibial/femoral lengths, tibial plateau angles, mechanical medial proximal and distal tibial angles, anatomical lateral distal femoral angles, femoral curvatum and neck anteversion were evaluated on postoperative radiographs and contralateral bone. Tibial torsion was evaluated visually. Paired t-test were used to compare data. Immediate postoperative complications were recorded.
Results Twenty-one tibial and 20 femoral fractures were stabilized (14 plate rod cases). Mean postoperative operated tibial length was 1.4% shorter (p = 0.001). Mean postoperative operated femoral length was 2% shorter (p = 0.04). Mean operated tibial plateau angle was 1.1° lower (p = 0.02). No difference in tibial torsion was noticed. No significant difference in mechanical medial proximal tibial angle, mechanical medial distal tibial angle, anatomical lateral distal femoral angle and femoral neck anteversion was observed. Mean operated femoral curvatum angle was 5.6° less (p = 0.01). Five cases (3 plate rod cases) required an immediate revision.
Clinical Significance Minimally invasive plate osteosynthesis with FRUP leads to acceptable postoperative alignment. Correct pin placement should be evaluated.
Dr. Cabassu contributed to conception of study, study design, acquisition of data and data analysis and interpretation along with drafting, revising the approving the submitted manuscript.
- 1 Peirone B, Rovesti GL, Baroncelli AB, Piras L. Minimally invasive plate osteosynthesis fracture reduction techniques in small animals. Vet Clin North Am Small Anim Pract 2012; 42 (05) 873-895
- 2 Lynch AC, Davies JA. Percutaneous tibial fracture reduction using computed tomography imaging, computer modelling and 3D printed alignment constructs: a cadaveric study. Vet Comp Orthop Traumatol 2019; 32 (02) 139-148
- 3 Babst R, Bavonratanavech S. Minimally Invasive Plate Osteosynthesis (MIPO). 2nd ed. Thieme Publishers; 2012
- 4 Schmökel HG, Stein S, Radke H, Hurter K, Schawalder P. Treatment of tibial fractures with plates using minimally invasive percutaneous osteosynthesis in dogs and cats. J Small Anim Pract 2007; 48 (03) 157-160
- 5 Boero Baroncelli A, Peirone B, Winter MD, Reese DJ, Pozzi A. Retrospective comparison between minimally invasive plate osteosynthesis and open plating for tibial fractures in dogs. Vet Comp Orthop Traumatol 2012; 25 (05) 410-417
- 6 Guiot LP, Déjardin LM. Prospective evaluation of minimally invasive plate osteosynthesis in 36 nonarticular tibial fractures in dogs and cats. Vet Surg 2011; 40 (02) 171-182
- 7 Smith WR, Ziran BH, Anglen JO, Stahel PF. Locking plates: tips and tricks. J Bone Joint Surg Am 2007; 89 (10) 2298-2307
- 8 Johnson KA. Piermattei’s Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th ed. St. Louis, MO: Elsevier Saunders; 2014:380–387, 431–437
- 9 Schmierer PA, Pozzi A. Guidelines for surgical approaches for minimally invasive plate osteosynthesis in cats. Vet Comp Orthop Traumatol 2017; 30 (04) 272-278
- 10 Perren SM. Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 2002; 84 (08) 1093-1110
- 11 Rashid MS, Aziz S, Haydar S, Fleming SS, Datta A. Intra-operative fluoroscopic radiation exposure in orthopaedic trauma theatre. Eur J Orthop Surg Traumatol 2018; 28 (01) 9-14
- 12 Bar-On E, Weigl DM, Becker T, Katz K, Konen O. Intraoperative C-arm radiation affecting factors and reduction by an intervention program. J Pediatr Orthop 2010; 30 (04) 320-323
- 13 Fettig AA, Rand WM, Sato AF, Solano M, McCarthy RJ, Boudrieau RJ. Observer variability of tibial plateau slope measurement in 40 dogs with cranial cruciate ligament-deficient stifle joints. Vet Surg 2003; 32 (05) 471-478
- 14 Unis MD, Johnson AL, Griffon DJ. , et al. Evaluation of intra- and interobserver variability and repeatability of tibial plateau angle measurements with digital radiography using a novel digital radiographic program. Vet Surg 2010; 39 (02) 187-194
- 15 Caylor KB, Zumpano CA, Evans LM, Moore RW. Intra- and interobserver measurement variability of tibial plateau slope from lateral radiographs in dogs. J Am Anim Hosp Assoc 2001; 37 (03) 263-268
- 16 Hady LL, Fosgate GT, Veterinary JWJO. Comparison of range of motion in Labrador Retrievers and Border Collies. Academic Journals 2015; 7 (04) 122-127
- 17 Guiot LP, Déjardin LM. . Fractures of the femur. In: Veterinary Surgery: Small Animal. 2nd ed. Philadelphia, PA: Elsevier; 2017
- 18 Schell H, Duda GN, Peters A, Tsitsilonis S, Johnson KA, Schmidt-Bleek K. The haematoma and its role in bone healing. J Exp Orthop 2017; 4 (01) 5
- 19 Grundnes O, Reikerås O. The importance of the hematoma for fracture healing in rats. Acta Orthop Scand 1993; 64 (03) 340-342