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DOI: 10.3415/VCOT-10-01-0001
Minimally invasive application of a radial plate following placement of an ulnar rod in treating antebrachial fractures
Technique and case seriesPublication History
Received:
11 January 2010
Accepted:
23 June 2010
Publication Date:
19 December 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035023/201006/lookinside/thumbnails/10-3415-vcot-10-01-0001-1.jpg)
Summary
Objective: To describe a surgical technique for placement of a minimally invasive radial plate following application of an ulnar rod (MIPR) for treatment of antebrachial fractures.
Methods: Medical records (November 2005-June 2009) were searched to identify dogs with diaphyseal radius and ulna fractures stabilised by MIPR. Data retrieved included signalment, weight, limb affected, cause of injury, open versus closed fracture, number of fragments, implant size, number of screws used and cortices engaged, number of open screw holes, operative time, rod removal, complications and time to radio-graphic healing. To be included, dogs had to have evidence of radiographic healing during follow-up.
Results: Eight dogs with diaphyseal radius and ulna fractures treated with MIPR were included in the case series. All fractures were due to trauma and two fractures were open (grade 1). Rod loosening and osteomyelitis of the ulna occurred in one case which subsequently resolved with rod removal. Healing occurred in all cases with no implant failures. Median time to radiographic union was 10.5 weeks (mean ± SD = 17 ± 15 weeks range 4–52 weeks).
Clinical relevance: Use of MIPR constructs on diaphyseal fractures of the radius and ulna is an effective technique for managing these fractures using principles of biological osteo-synthesis. An intramedullary rod in the ulna assists with fracture reduction and stabilisation and rod removal is recommended once fracture healing has occurred.
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References
- 1 Harasen G. Common long bone fractures in small animal practice – part 1. Can Vet J 2003; 44: 333-334.
- 2 Harasen G. Common long bone fractures in small animal practice – part 2. Can Vet J 2003; 44: 503-504.
- 3 Phillips IR. A survey of bone fractures in the dog and cat. J Small Anim Pract 1979; 20: 661-674.
- 4 Anderson GM, Lewis DD, Radasch RM. et al. Circular External Skeletal Fixatation Stabilization of Antebrachial and Crural Fractures in 25 Dogs. J Am Anim Hosp Assoc 2002; 39: 479-498.
- 5 Rovesti GL, Bosio A, Marcellin-Little DJ. Management of 49 antebrachial and crural fractures in dogs using circular external fixators. J Small Anim Pract 2007; 48: 194-200.
- 6 Sardinas JC, Montavon PM. Use of a medial bone plate for repair of radius and ulna fractures in dogs and cats: a report of 22 cases. Vet Surg 1997; 26: 108-113.
- 7 Johnson AL, Houlton JEF, Vannini R. AO Principles of Fracture Management in the Dog and Cat. Davos Platz, Switzerland: AO Publishing 2005
- 8 Reems MR, Beale BS, Hulse DA. Use of a plate-rod construct and principles of biological osteosynthesis for repair of diaphyseal fractures in dogs and cats: 47 cases (1994–2001). J Am Vet Med Assoc 2003; 223: 330-335.
- 9 Palmer RH. Biological osteosynthesis. Vet Clin North Am Small Anim Pract 1999; 29: 1171-1185. vii
- 10 Hudson C, Pozzi A, Lewis D. Minimally invasive plate osteosynthesis: Applications and techniques in dogs and cats. Vet Comp Orthop Traumatol 2009; 22: 175-182.
- 11 Pozzi A, Lewis D. Surgical approaches for minimally invasive plate osteosynthesis in dogs. Vet Comp Orthop Traumatol 2009; 22: 316-320.
- 12 Baumgaertel F, Buhl M, Rahn BA. Fracture healing in biological plate osteosynthesis. Injury 1998; 29 (Suppl. 03) Suppl C3-6.
- 13 Horstman CL, Beale BS, Conzemius MG. et al. Biological osteosynthesis versus traditional anatomic reconstruction of 20 long-bone fractures using an interlocking nail: 1994-2001. Vet Surg 2004; 33: 232-237.
- 14 Johnson AL. Current concepts in fracture reduction. Vet Comp Orthop Traumatol 2003; 16: 59-66.
- 15 Johnson AL, Smith CW, Schaeffer DJ. Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987–1997). J Am Vet Med Assoc 1998; 213: 1157-1161.
- 16 Farouk O, Krettek C, Miclau T. et al. Minimally invasive plate osteosynthesis: does percutaneous plating disrupt femoral blood supply less than the traditional technique?. J Orthop Trauma 1999; 13: 401-406.
- 17 Farouk O, Krettek C, Miclau T. et al. Effects of percutaneous and conventional plating techniques on the blood supply to the femur. Arch Orthop Trauma Surg 1998; 117: 438-441.
- 18 Wagner M. General principles for the clinical use of the LCP. Injury 2003; 34 (Suppl. 02) Suppl B31-42.
- 19 Wagner M, Frigg R. AO Manual of Fracture Management: Internal Fixators. Davos Platz, Switzerland: AO Publishing 2006
- 20 Schmokel HG, Hurter SPK. Percutaneous plating of tibial fractures in two dogs. Vet Comp Orthop Traumatol 2003; 16: 191-195.
- 21 Lau TW, Leung F, Chan CF. et al. Wound complication of minimally invasive plate osteosynthesis in distal tibia fractures. Int Orthop 2008; 32: 697-703.
- 22 Oh CW, Park BC, Kyung HS. et al. Percutaneous plating for unstable tibial fractures. J Orthop Sci 2003; 08: 166-169.
- 23 Ziran BH, Belangero W, Livani B. et al. Percutaneous plating of the humerus with locked plating: technique and case report. J Trauma 2007; 63: 205-210.
- 24 Hulse D, Hyman W, Nori M. et al. Reduction in plate strain by addition of an intramedullary pin. Vet Surg 1997; 26: 451-459.
- 25 Hulse D, Ferry K, Fawcett A. et al. Effect of intramedullary pin size on reducing bone plate strain. Vet Comp Orthop Traumatol 2000; 13: 185-190.
- 26 Guiot LP, Dejardin LM. Minimally invasive percutaneous plate-rod osteosynthesis for treatment of extra-articular humeral fractures in dogs. In: Abstracts from the American College of Veterinary Surgeons Symposium; 2009 October 8-10. Washington, D.C., USA: Printed in: Vet Surg; 2009. 38 E32-33.
- 27 Fox DB, Tomlinson JL, Cook JL. et al. Principles of uniapical and biapical radial deformity correction using dome osteotomies and the center of rotation of angulation methodology in dogs. Vet Surg 2006; 35: 67-77.
- 28 Meola SD, Wheeler JL, Rist CL. Validation of a technique to assess radial torsion in the presence of procurvatum and valgus deformity using computed tomography: a cadaveric study. Vet Surg 2008; 37: 525-529.
- 29 Halling KB, Lewis DD, Cross AR. et al. Complication rate and factors affecting outcome of olecranon osteotomies repaired with pin and tension-band fixation in dogs. Can Vet J 2002; 43: 528-534.
- 30 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: 1093-1110.
- 31 Schmökel HG, Stein H. et al. Treatment of tibial fractures with plates using minimally invasive percutaneous osteosynthesis in dogs and cats. J Small Anim Pract 2007; 48: 157-160.
- 32 Haaland P, Sjöström L, Devor M. et al. Appendicular fracture repair in dogs using the locking compression plate system: 47 cases. Vet Comp Orthop Traumatol 2009; 22: 309-315.
- 33 Schwandt CS, Montavon PM. Locking compression plate fixation of radial and tibial fractures in a young dog. Vet Comp Orthop Traumatol 2005; 18: 194-198.
- 34 Pozzi A, Hudson C. Minimally invasive plate osteo-synthesis for radial fractures. In: Proceedings of the 18th Annual American College of Veterinary Medicine Symposium San Diego, CA, USA: 2008. October 23-25 g. 300.
- 35 Pozzi A, Hudson C, Lewis D. Minimally invasive plate osteosynthesis: initial clinical experience in 10 cases. In: Proceedings of the 35th Annual Veterinary Orthopedic Society Conference Big Sky, MT, USA: 2008. March 8-15 g. 85.
- 36 Imatani J, Noda T, Morito Y. et al. Minimally invasive plate osteosynthesis for comminuted fractures of the metaphysis of the radius. J Hand Surg Br 2005; 30: 220-225.
- 37 Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury 2003; 34 (Suppl. 02) Suppl B63-76.
- 38 Sanders R, Haidukewych GJ, Milne T. et al. Minimal versus maximal plate fixation techniques of the ulna: the biomechanical effect of number of screws and plate length. J Orthop Trauma 2002; 16: 166-171.
- 39 Goh CS, Santoni BG, Puttlitz CM. et al. Comparison of the mechanical behaviors of semicontoured, locking plate-rod fixation and anatomically contoured, conventional plate-rod fixation applied to experimentally induced gap fractures in canine femora. Am J Vet Res 2009; 70: 23-29.
- 40 Aguila AZ, Manos JM, Orlansky AS. et al. In vitro biomechanical comparison of limited contact dynamic compression plate and locking compression plate. Vet Comp Orthop Traumatol 2005; 18: 220-226.
- 41 Krettek C, Muller M, Miclau T. Evolution of minim-ally invasive plate osteosynthesis (MIPO) in the femur. Injury 2001; 32 (Suppl. 03) Suppl SC14-23.
- 42 Pantos I, Patatoukas G, Katritsis DG. et al. Patient radiation doses in interventional cardiology procedures. Curr Cardiol Rev 2009; 5: 1-11.
- 43 Jones DG, Stoddart J. Radiation use in the orthopaedic theatre: a prospective audit. Aust N Z J Surg 1998; 68: 782-784.
- 44 Tasbas BA, Yagmurlu MF, Bayrakci K. et al. Which one is at risk in intraoperative fluoroscopy? Assistant surgeon or orthopaedic surgeon?. Arch Orthop Trauma Surg 2003; 123: 242-244.
- 45 Theocharopoulos N, Perisinakis K, Damilakis J. et al. Occupational exposure from common fluoroscopic projections used in orthopaedic surgery. J Bone Joint Surg Am 2003; 85A: 1698-1703.