Key result
MIPO technique linked to ~127 fewer days of external skeletal fixation versus fixation alone.
Why the study?
The use of the minimally invasive plate osteosynthesis technique with a locking compression plate in bone lengthening has not been established, and shortening the external skeletal fixation period is desirable.
Does the MIPO technique using an LCP shorten the external skeletal fixation period in patients undergoing femoral lengthening?
Observational (n=9)
No
Does the MIPO technique using an LCP shorten the external skeletal fixation period in patients undergoing femoral lengthening?
Absolute Event Rate: 134% vs 260.5%
The MIPO technique using an LCP may shorten the external skeletal fixation-wearing period in femoral lengthening.
May shorten external fixation time in femoral lengthening; hypothesis-generating and requires prospective validation before practice change.
A minimally invasive plate osteosynthesis technique using a locking compression plate (LCP) has been used widely in trauma cases. Its advantages are that the MIPO technique does not interfere with the fracture site and thus provides improved biological healing, and that the LCP has excellent angular stability. Its use in bone lengthening, however, has not been established. In such cases, it is desirable to shorten the external skeletal fixation period as much as possible. Here, the MIPO technique using an LCP was applied to femoral distraction osteogenesis in an attempt to shorten the external skeletal fixation period. For femoral lengthening, the MIPO technique was performed in 2 stages. Orthofix external fixators (Orthofix, England) were used to insert screws from the anterolateral side rather than from the lateral side of the femur for bone lengthening. When sufficient callus formation was detected postoperatively at the site of bone lengthening, and the absence of infection was ensured, limb draping was performed, including a whole external fixator, and then the MIPO technique was applied with an LCP.In 3 cases (5 limbs), the average duration of external skeletal fixation was 134 days, the average external-fixation index was 24 days/cm, and the average consolidation index was 22 days/cm. The MIPO technique using an LCP made it possible to shorten the external skeletal fixation-wearing period in femoral lengthening.
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Endo et al. (2008) conducted an observational in Femoral lengthening (short-limbed dwarfism, leg length discrepancy) (n=9). Minimally invasive plate osteosynthesis (MIPO) technique with a locking compression plate (LCP) vs. External skeletal fixation only was evaluated on Duration of external skeletal fixation. The MIPO technique using a locking compression plate for femoral lengthening shortened the average duration of external skeletal fixation to 134 days compared to 260.5 days with external fixation alone.
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