MINIMAL INVASIVE SURGERY OF CLOSED LOWER LIMB FRACTURES: EXPERIENCES IN 90 CASES

Abstract

Fractures of lower limb treated with Open Reduction and Internal Fixation (O.R.I.F.) are frequently complicated in the postoperative period. Minimal Invasive Plate Osteosynthesis (MIPO) is developing for subcutaneous plating. The purpose of this study is to demonstrate the improvement in dropping the risks of complications following internal fixation using MIPO. From January 1998 to May 1999 we collected 32 cases of lower limb fractures treated with O.R.I.F (Group I). From June 1999 we started to perform MIPO in closed fractures of lower limb with conventional and new devices with angular stability that offer more mechanical stability (Group II 90 cases). In Group I we got 2 infections in pilon fractures, 3 delayed union in distal tibial fractures, 1 non-union in distal femoral fracture, 1 varus deformity in distal femoral fracture and 2 DVT. In Group II we had only 4 cases of varus deformity and 1 DVT.

The findings of this study justify the effort to follow this procedure also because the new devices available improved mechanical stability. MIPO is a demanding technique with undoubted advantages: it respects the biology of callus and soft tissues, it reduces the necessity of bone graft and is particularly indicated in polytrauma patients.