Fracture Healing Biological Plate Osteosynthesis Ucla Essay Prompt
A recent canine cadaveric study was performed comparing the use of the MIRIS and a two-ring circular construct to facilitate alignment and reduction during MIPO applications using a comminuted radius and ulna fracture model .
The MIRIS allowed for shorter reduction times and simplified plate placement, without compromise to fracture reduction and alignment .
Postoperatively, dogs were given intermittent intravenous methadone (0.1–0.2 mg/kg) boluses every 4–6 hours for 24 hours following surgery.
Colorado pain scores were assessed every 4 hours following surgery to discharge and used to direct the analgesic protocol.
Inappropriate implant selection was considered the primary reason for implant failure.
All three fractures achieved union by 10 weeks following surgery.
The MIRIS facilitated efficient MIPO in all three fractures.
All three dogs had excellent limb function at the time of the final evaluation.The MIRIS was used, as previously described by Gilbert et al., to reduce and align the fractures prior to MIPO.The objective of this case series was to report our initial clinical results using the MIRIS to facilitate MIPO applications in three dogs with diaphyseal appendicular fractures.Three dogs were presented for stabilization of long bone fractures (Table 1).Radiographs obtained 3 weeks after implant removal necessitated by infection (e).All three dogs were anesthetized using the same anesthetic protocol.Iatrogenic soft tissue trauma and disturbance of the fracture environment are limited as implants are applied via small plate insertion incisions made remote to the fracture site [1–7].Purported advantages afforded by this technique include reduced operative times compared to open anatomic fracture reconstruction [2, 10], low infection rates due to the shorter duration of surgery and limited exposure of the fracture site [8, 11–14], and shorter times to union ascribed to maintenance of the fracture hematoma and preservation of periosteal blood supply [15–17].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).