By Reto Babst, Suthorn Bavonratanavech
This textbook deals a entire view of all features of minimally
invasive plate osteosynthesis (MIPO). the second one extended version comprises the
expert wisdom of AO surgeons from everywhere in the global. It not just offers
basic thoughts and the most recent scientific and easy medical examine, yet publications
the medical professional during the the most important steps of MIPO program within the
different anatomical regions.
Enhanced by way of transparent images, x-rays, MRls, CT scans, and special
illustrations, the booklet contains sections:
- Section 1, ideas, covers the rules of MIPO surgical procedure in addition to
schooling in MIPO.
- Section 2, circumstances, encompasses all anatomical areas. for every zone
there's a finished creation masking common facets of MIPO
innovations concerning symptoms, preoperative making plans, and positioning,
prior to oblique and direct relief and fixation recommendations are offered.
Case examples then enable the reader to stick with every one strategy in an intensive,
step by step demeanour. extra chapters on pediatric and fragility fractures,
distinct symptoms, and implant elimination finish this moment section.
The major proposal in the back of the MIPO method is to accommodate tender tissue and
bone in a manner that doesn't upload extra trauma to the fracture web site. The bone
must be accessed via soft-tissue home windows clear of the fracture website. Direct
reduction maneuvers, if wanted, can be carried out to depart simply small
footprints on the fracture sector and decrease disturbance of fracture
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Additional resources for Minimally Invasive Plate Osteosynthesis (MIPO)
In future, preoperative planning will likely be performed using parametric mechanical data instead of images. indb 20 9/8/06 12:02:58 PM 2 Mechanobiology Angular stable implants may become standard as angular stability provides a way to control and limit excessive interfragmentary motion. However, stress will increase within the implant and failure can still occur. As with all trauma surgery, proper knowledge and training, preoperative planning, technically well-executed surgery, comprehensive rehabilitation, and timely follow-up will result in a predictably good outcome even in the most difﬁcult of fractures.
This is critical especially when dealing with complex and segmental fractures involving the joint, metaphysis, and diaphysis. Efficacy of a helical plate with regard to torsional (a) bending (b), and axial (c) loads. a Biomechanical considerations in preoperative planning Under axial loading, the fracture gap closure is quite uniform, unlike that of the conventional straight plate. Absolute stability is best indicated in articular fractures and can be achieved by interfragmentary compression using the appropriate lag screw technique.
Pacts against the angled side of the hole, results in b Like a ball, the screw head slides down the inclined cylinder. movement of the plate and the fracture fragment c–d Since the screw head is ﬁ xed to the bone via the screw hole, it can only move vertically, in relation to the bone. already attached to the plate by the ﬁrst screw (1). This leads to compression of the fracture. indb 37 9/8/06 12:03:20 PM 5 Implants for MIPO Broadly speaking, MIPO can be performed with the following types of implants: Locking plates, eg, LCP and LISS Conventional plates, eg, straight plates, such as DCP and LC-DCP, and ﬁ xed angle implants, such as condylar plates 95º or DCS 6 a b Fig 4-7a–b a b 4 MIPO in proximal femur using a condylar plate 95°.