Minimally invasive plate osteosynthesis and vascularity: preliminary results of a cadaver injection study

• Published in: Injury Vol. 28; pp. A7 - A12
• Main Authors: Farouk, O., Krettek, C., Miclau, T., Schandelmaier, P., Guy, P., Tscherne, H.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 1997
• Subjects: Aged; Aged, 80 and over; Arteries - injuries; Arteries - physiopathology; blood supply; Bone Plates; Cadaver; femoral fracture; Femoral Fractures - surgery; Femur - blood supply; Fracture Fixation, Internal - adverse effects; Fracture Fixation, Internal - methods; Humans; injection study; internal fixation; Middle Aged; minimally invasive; Minimally Invasive Surgical Procedures - methods; Percutaneous plate; Periosteum - blood supply; Regional Blood Flow; Silicones; injection study; minimally invasive; blood supply; internal fixation; Percutaneous plate; femoral fracture
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/S0020-1383(97)90110-8

A cadaver arterial injection study was performed to analyse the vascular supply to the femur and to study the effects of two surgical plating techniques on femoral vascularity. A 16-hole LC-DCP was applied on the intact femora of five fresh human cadavers. On one side, the plate was inserted using a conventional lateral plate osteosynthesis (CLPO) technique with elevation of the vastus lateralis muscle to expose the shaft. On the contralateral side, the plate was inserted percutaneously beneath the muscle using a minimally invasive plate osteosynthesis (MIPO) technique. After plating, blue silicone dye was injected through the common femoral artery. Cadaveric dissection was then performed to identify the femoral perforating arteries (PAs) and the nutrient artery (NA) of the femur. The pattern of periosteal filling and medullary perfusion of the injected dye was analysed and the topography of the PAs and NA was determined. CLPO placed the PAs and NA of the femur at risk. MIPO maintained the integrity of the PAs and NA and was associated with superior periosteal and medullary perfusion. The results of this study indicate that MIPO is superior to the CLPO in maintaining arterial femoral vascularity and perfusion.