Callus Formation and Mineralization after Fracture with Different Fixation Techniques: Minimally Invasive Plate Osteosynthesis versus Open Reduction Internal Fixation.

Haitao Xu,Zichao Xue,Zhiquan An,Hui Qin,Haoliang Ding,Jan Peter Tuckermann

doi:10.1371/journal.pone.0140037

Abstract

Minimally invasive plate osteosynthesis(MIPO) has been considered as an alternative for fracture treatment. Previous study has demonstrated that MIPO technique has the advantage of less soft tissue injury compared with open reduction internal fixation (ORIF). However, the comparison of callus formation and mineralization between two plate osteosynthesis methods remains unknown. In this experiment, ulna fracture model was established in 42 beagle dogs. The fractures underwent reduction and internal fixation with MIPO or ORIF. Sequential fluorescent labeling and radiographs were applied to determine new callus formation and mineralization in two groups after operation. At 4, 8 and 12 weeks postoperatively, the animals were selected to be sacrificed and the ulna specimens were analyzed by Micro-CT. The sections were also treated with Masson staining for histological evaluation. More callus formation was observed in MIPO group in early stage of fracture healing. The fracture union rate has no significant difference between two groups. The results indicate that excessive soft tissue stripping may impact early callus formation. As MIPO technique can effectively reduce soft tissue injury with little incision, it is considered to be a promising alternative for fracture fixation.

Highlights

There are a variety of options when operative treatment for fractures is required, among which, open reduction internal fixationis the most commonly used method and has obtained good outcomes, with the advantage of anatomical reduction[1,2,3,4]
Group A was treated with minimally invasive plate osteosynthesis (MIPO) and synthesis locking compression plate (LCP), and Group B with open reduction internal fixation (ORIF) and LCP. 7 dogs were randomly selected in each group to be sacrificed with 10% potassium chlorideat 4, 8 and 12 weeks postoperatively
We found that the plate insertion tunnel was not epiperiosteal in MIPO group, while the periosteal stripping was observed in ORIF group, which was corresponding to the cadaveric study of Forouk

Summary

Introduction

There are a variety of options when operative treatment for fractures is required, among which, open reduction internal fixationis the most commonly used method and has obtained good outcomes, with the advantage of anatomical reduction[1,2,3,4]. Many studies have reported the superiority of minimally invasive plate osteosynthesis (MIPO)[9,10,11,12,13].

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Conclusion