The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture

Seong-Jun Ahn; Suk-Woong Kang; Bu-Hwan Kim; Moo-Ho Song; Seong-Ho Yoo; Kwan-Taek Oh

doi:10.12671/jkfs.2013.26.4.314

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Ahn, Kang, Kim, Song, Yoo, and Oh: The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture

Original Article

Journal of the Korean Fracture Society 2013; 26(4): 314-320.

Published online: 18 October 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.4.314

The Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis versus Open Plate Fixation in the Treatment of in the Distal Femur Fracture

Seong-Jun Ahn, M.D., Suk-Woong Kang, M.D., Bu-Hwan Kim, M.D., Moo-Ho Song, M.D., Seong-Ho Yoo, M.D., Kwan-Taek Oh, M.D.

Department of Orthopaedic Surgery, Daedong Hospital, Busan, Korea.

Address reprint requests to: Suk-Woong Kang, M.D. Department of Orthopaedic Surgery, Daedong Hospital, 187 Chungnyeol-daero, Dongnae-gu, Busan 607-711, Korea. Tel: 82-51-554-8996, Fax: 82-51-553-7575, redmaniak@naver.com

Received 2 May 2013 Revised 27 July 2013 Accepted 9 September 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the efficacy of surgical treatment through retrospective comparison of minimally invasive percutaneous plate osteosynthesis (MIPPO) vs open plate fixation in the treatment of the distal femur fractures.

Materials and Methods

Thirty-one patients with distal femur fractures from January 2002 to December 2010 were divided into two groups depending on the surgical method. Minimum follow up was 12 months. Group A consisted of 17 patients treated with MIPPO, and group B was comprised of 14 patients treated with open plate fixation. Clinical outcomes including operation time, transfusion rate, rehabilitation, range of motion, and interval change of postoperative C-reactive protein (CRP) were evaluated to assess postoperative inflammatory reaction, postoperative complications and clinical results with the use of Sanders criteria.

Results

The operative time was 86/135 min and transfusion volume was 0.8/1.9 unit respectively. The postoperative 3-day and 7-day CRP were 7.4/1.5 mg% in group A and 10.3/2.4 mg% in group B, showing more minimal tissue injury and early recovery in group A. There were no significant differences in clinical results by Sanders criteria in both groups.

Conclusion

Both MIPPO and open plate fixation for the treatment of distal femur fractures showed comparably good results. However, the MIPPO technique is superior to group B in view of minimal tissue injury and operation time and was proven to lessen the transfusion rate.

Keywords: Distal femoral fracture, Minimally invasive percutaneous plate osteosynthesis, Open plate fixation

Figures and Tables

Fig. 1

(A) A 66-year-old woman, AO/OTA classification 33-C1.

(B) Radigraphs show a postoperative state which was treated by the minimally invasive percutaneous plate osteosynthesis technique.

(C) The last follow up radiograph shows complete bone union.

Fig. 2

(A) A 72-year-old woman, AO/OTA classification 33-A3.

(B) Radigraphs show a postoperative state which was treated by open reduced and internal fixation.

(C) The last follow up radiograph shows complete bone union.

Fig. 3

The postoperative CRP changes in group A and B, showing more minimal tissue injury and early recovery. CRP: C-reactive protein, MIPPO: Minimally invasive percutaneous plate osteosynthesis.

Table 1

Demographic Data, AO/OTA Classification

Values are presented as number or mean (range). MIPPO: Minimally invasive percutaneous plate osteosynthesis, Pre-CRP: Preoperative C-reactive protein. ^*Mann-Whitney U test, ^†Fisher's exact test.

Table 2

Comparison of the Operative Time and Transfusion

Values are presented as mean (range) or % (number) or average unit. MIPPO: Minimally invasive percutaneous plate osteosynthesis. ^*Mann-Whitney U test, ^†Fisher's exact test.

Table 3

Radiologic Result and Rehabilitation

Values are presented as mean (range). MIPPO: Minimally invasive percutaneous plate osteosynthesis, ROM: Range of motion. ^*Mann-Whitney U test.

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