Fracture Healing Biological Plate Osteosynthesis

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This system resulted in reductions that were near anatomic, with acceptable restoration of length and alignment and excellent limb function.

Minimally invasive plate osteosynthesis (MIPO) is utilized in both human and veterinary orthopedics and embraces the principles of biological fracture stabilization [1–9].

Implant failure was documented 7 days after surgery (c).

The fracture was restabilized via application of an 11-hole, 3.5 mm LCP plate (d).

The time elapsed from when each dog sustained the fracture to initial surgical stabilization ranged from 2 to 3 days.

Dogs were given intermittent methadone (0.1–0.2 mg/kg) boluses every 4–6 hours for pain control prior to surgery.The MIRIS was used, as previously described by Gilbert et al.[23], to reduce and align the fractures prior to MIPO.Figure 2: Craniocaudal and mediolateral preoperative radiographs of dog #1’s left radius and ulna fractures (a).Initial postoperative radiographs following primary surgical stabilization with a 9-hole, 2.7 mm locking compression plate (b).Figure 4: Craniocaudal preoperative radiographs of dog #3’s right tibial fracture (a).Initial postoperative radiographs following primary surgical stabilization with a 12-hole, 2.7 mm locking compression plate and a 10-hole, 2.0 mm String of Pearls plate (b).All dogs had closed diaphyseal spiral fractures: one radius and ulnar fracture (Figure 2) and two tibial and fibular fractures with comminution (Figures 3 and 4).Prior to surgery, all dogs underwent digital radiography, with orthogonal views obtained of the fractured and contralateral limb segment.Several indirect reduction techniques have been described to aid MIPO applications in dogs [7, 18–22].The Minimally Invasive Reduction Instrumentation System [MIRIS] (De Puy Synthes, Paoli, PA) is a unilateral, linear fixator system marketed for use during MIPO applications in human patients (Figure 1).

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