TOTBİD Dergisi

TOTBİD Dergisi

2012, Cilt 11, Sayı, 1     (Sayfalar: 001-014)

Minimally invasive osteosynthesis: basic principles, surgical planning and reduction techniques

Uğur Gönç 1, K. Kürşat Teker 1, Reha Tandoğan 1, Asım Kayaalp 1

1 Özel Çankaya Hastanesi, Ortopedi ve Travmatoloji Bölümü, Ankara

DOI: 10.5606/totbid.dergisi.2012.01
Görüntüleme: 67
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İndirme : 78

In the recent years many important changes have been introduced in the treatment of fractures. The aim of conventional plate osteosynthesis is to perform anatomical reductions and stabilization of the fracture fragments through compression. Mechanical stability is the main goal of the conventional plate osteosynthesis. Deeper understanding of the effects of the biology of fractures on fracture healing and the introduction of the concept of relative stability rather than absolute stability have led to the development of biological fixation methods. When successful results of splinting techniques using intramedullary nails or external fixators were achieved, the concept of using plates in the same manner by means of bridge plating became more popular. The next step of the biological fixation with plates was the development of percutaneous plating techniques. In minimally invasive plate osteosynthesis, the blood supply of the fracture is preserved, as the fracture zone is left intact. The fracture is reduced by indirect reduction and plate is applied percutaneously through small incisions far away from the fracture site. Longer plates with a few screws are used for splinting the fracture. In recent years, development of locking plates and new surgical instruments specifically designed for minimally invasive surgery has allowed minimally invasive osteosynthesis to become a widely used technique. Although minimally invasive plate osteosynthesis is consistent with the biology, it is a challenging technique and may lead to several complications such as malalignment following indirect reduction. As a result, a detailed surgical planning is required for successful results. In addition, surgeon should be familiar with not only different reduction techniques, but also methods for controlling the reduction achieved during surgery.

Anahtar Kelimeler : Biological fixation; indirect reduction; locking plate; minimally invasive osteosynthesis; percutaneous plating