ISSN 2398-2950      

Biological fracture fixation

ffelis
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Synonym(s): Minimally invasive plate osteosynthesis, MIPO if plate and screws used


Introduction

  • Surgical repair of comminuted long bone fractures in animals is shifting from the traditional, mechanical emphasis of anatomic reconstruction to a more functional, biological approach.
  • As with many other veterinary protocols, this trend in orthopedic surgery has been adapted from human studies performed in the late 1980s and early 1990s.
  • Successful clinical results using this method of biological fracture fixation (also termed bridging osteosynthesis of indirect reduction) are now routinely appearing in the veterinary clinical journals and have become standard textbook inclusions. 
    In both injured people and animals, faster healing and fewer complications have been reported with biological fixation methods compared to anatomic reconstruction.
  • Clinicians who perform orthopedic surgery should consider the biological approach for fracture fixation in lieu of attempts to anatomically reconstruct comminuted bone segments.
  • Surgeons have several options including bone plates Fracture fixation: plate, interlocking nails Fracture fixation: interlocking nail Fracture: internal fixation, and external fixators Fracture: external fixation Fracture fixation: external skeletal fixator in treating these complex fractures. Preservation of hard and soft tissue integrity along with utilization of stable implants are the keys for reduction of patient morbidity and a return to function.

Problems with fracture fixation

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Biological approach

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Indications for biological approach

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Post-operative care

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Reems M R, Beale B S & Hulse D A (2003) Use of a plate-rod construct and principles of biological osteosynthesis for repair of diaphyseal fractures in dogs and cats: 47 cases (1994-2001). JAVMA 223 (3), 330-335 PubMed.
  • Johnson A L, Smith C W & Schaeffer D J (1998) Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997).​ JAVMA 213 (8), 1157-1161 PubMed.
  • Hulse D, Human W, Nori M et al (1997) Reduction in plate strain by addition of an intramedullary pin. Vet Surg 26 (6), 451-459 PubMed.
  • Aron D N, Johnson & Palmer R H (1995) Biologic strategies and a balanced concept for repair of highly comminuted long bone fractures. Comp Cont Educ Pract Vet 17 (1), 35-49 VetMedResource.

Other sources of information

  • Palmer R H (1999) Biological osteosynthesis. Vet Clin North Am Sm Anim Pract 29, 1171-1185 PubMed.

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