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Figure 3: Craniocaudal and mediolateral preoperative radiographs of dog #2’s right tibial and fibula fractures (a).Initial postoperative radiographs following primary surgical stabilization with a 12-hole, 2.7 mm locking compression plate and a 10-hole, 2.7 mm String of Pearls plate (b).Figure 4: Craniocaudal preoperative radiographs of dog #3’s right tibial fracture (a).
This system resulted in reductions that were near anatomic, with acceptable restoration of length and alignment and excellent limb function.
Minimally invasive plate osteosynthesis (MIPO) is utilized in both human and veterinary orthopedics and embraces the principles of biological fracture stabilization [1–9].
The dog that underwent revision surgery developed a surgical site infection 5 months following revision surgery, which necessitated implant removal.
All three dogs had excellent limb function at the time of the final evaluation.
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).
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).