Minimally Invasive Plate Osteosynthesis Technique Research Articles

Management of diaphyseal tibial fractures by plate fixation with absolute or relative stability: a retrospective study of 45 patients

BackgroundFixation of diaphyseal tibial fractures by plates is not considered the best option due to complications that may eventually arise; however, if principles of stability and proper surgical techniques are...

Minimally invasive plate osteosynthesis technique for displaced midshaft clavicular fracture using the clavicle reductor.

This study aims to introduce a self-designed clavicle reductor and to test the effectivity of a alternative minimally invasive plate osteosynthesis technique (MIPO) for displaced midshaft clavicular fractures (DMCFs) with the application of our self-designed clavicle reductor. From October 2012 to February 2013, 27 male patients who suffered with unilateral displaced midshaft clavicular fracture (DMCFs) were included into our study. Patients were treated by minimally invasive plate osteosynthesis (MIPO) technique with the application of our self-designed clavicle reductor and followed up regularly. Constant-Murley score was employed to test the functional outcomes at one year's follow up. The average follow-up time for the 27 patients was 15.8months (range, 13-18months). The average age of all patients was 32.6 (range, 21 to 48). According to OTC system, 12 cases were simple fractures (15-B1), ten cases were wedge fractures (15-B2) and five cases were comminuted fractures (15-B3). With the application of the clavicle reductor, minimally invasive plate osteosynthesis technique can be performed without any barrier in all of the 27 cases. Operative duration was 48.1minutes (range, 35-65minutes) and average fluoroscopy time was 12.8seconds (range, from 7 to 22seconds). All of the 27 cases healed from four to sixmonths post-operatively. The average Constant-Murley-score of the 27 patients was 92.7 ± 5.88 (range, 80 to 100). No complications were noted. The self-designed clavicle reductor can effectively pave the way for the application of MIPO technique in the treatment of DMCFs. MIPO technique with locking reconstruction plate is a feasible and worthwhile alternative for displaced midshaft clavicular fractures (DMCFs).

Guidelines for surgical approaches for minimally invasive plate osteosynthesis in cats.

Minimally invasive plate osteosynthesis (MIPO) is one of the most recent fixation techniques that embody the concept of biological osteosynthesis. Several studies evaluating MIPO in dogs have been published in the recent years. However, there are few clinical reports of MIPO in cats and no description of the surgical approaches. The purpose of our study was to describe the safe corridors for plate insertion in cats using the MIPO technique. The surgical approaches for the humerus, radius-ulna, femur and tibia were developed after reviewing the described techniques and surgical approaches for MIPO in dogs, while considering any relevant anatomical difference between dogs and cats. Following the MIPO approaches, the limbs were anatomically dissected and the relationship between proximal and distal positions of the implants and neurovascular structures was noted. The surgical approaches developed for the humerus and radius-ulna differed from what had been reported previously, because relevant anatomical differences were found between dogs and cats. Anatomical landmarks for safe plate application were described for all the major long bones in cats. No damage to vital structures following plate insertion was detected in the dissection. In this cadaveric study, we evaluated the safety of the surgical approaches for MIPO in cats. By respecting the anatomical landmarks described in this report, damage to the neurovascular structures can be avoided performing the MIPO technique in cats.

Midshaft Clavicular Fractures - Osteosynthesis with Minimally Invasive Technique.

BACKGROUND:Fractures of the clavicle are one of the most common fractures in modern orthopaedics and traumatology practice. Knowing the mechanism of trauma, and it’s pathophysiological elements, it’s clear distinction and it’s individual features are essential to the development of more new and effective methods for their treatment, and the minimising of postoperative complications.AIM:The aim of this paper was to present the results of our patients treated with minimally invasive plate osteosynthesis (MIPO).MATERIAL AND METHODS:Between January 2011 and March 2013, 12 patients were treated with MIPO technique. The mean age was 47.5 years (range, 16-79 years). Outcomes and complications of clinical treatment were reviewed.RESULTS:All fractures healed within a mean period of 4.9 months (range, 2-10 months). Regarding complications, there was no occurrence of implant failure or deep infection. There were no nonunions, but one 79-year-old man had a delayed union. Almost of all the cases didn’t need bending of the plate. Seven plates were removed by their hopes. And there weren’t any cases that required new incisions.CONCLUSIONS:A pre-contoured plate anatomically configured to fit the clavicle was easier to apply. MIPO technique for midshaft clavicle fractures may be a good option.

Résultats de l’ostéosynthèse par plaque antérieure et abord mini-invasif (MIPO) des fractures de l’extrémité distale du radius : mise au point

Minimally invasive plate osteosynthesis (MIPO) has been used in recent years to treat fractures of the distal radius with volar locking plates. Its advantages are the preservation of the pronator quadratus and good esthetics. The MIPO technique was described originally with two incisions: one distal transverse or longitudinal incision and one proximal longitudinal incision. The trend is now to use a single longitudinal incision less than 20mm long. Functional and radiological outcomes are comparable to those of conventional techniques. The MIPO technique is indicated for extra-articular and intra-articular fractures. Arthroscopy may be used concurrently in the latter case. When the distal radius fracture is associated with a proximal shaft fracture, a double incision is needed to introduce a longer plate. The relative contraindications of the MIPO technique are comminuted intra-articular fractures in osteoporotic elderly patients. If reduction is problematic, a larger incision can easily be made.

Minimally Invasive Plate Osteosynthesis of Comminuted One Bone Fractures of Forearm Shaft

Objective: Due to rotatability of the forearm, open reduction and internal fixation with plate is a gold standard treatment of forearm fracture. Our hypothesis was that if it does not make any problems on alignment and rotation, minimally invasive plate osteosynthesis (MIPO) technique could be also applied for forearm fracture. It is easy to align when only one of forearm bone is fractured because reference point exists. The purpose of this study is to introduce MIPO technique for comminuted one bone fracture of forearm shaft. Methods: Between May 2011 and January 2014, 17 patients with fractures of forearm shaft were treated by MIPO technique. MIPO technique was applied to single forearm bone shaft fractures or to the more severe comminuted bone when both forearm bones are fractured. The other less sever bone fracture is treated with open reduction and internal fixation. There were 5 cases of forearm both bone fracture (radius 3, ulna 2), 5 cases of radius shaft fracture, and 7 cases of ulnar shaft fracture. MIPO technique was applied in total 8 cases of radius fracture and 9 cases of ulna fracture. The mean follow-up period was 26 months (range, 24-44 months). Bone union period was determined by radiographs taken upon follow up, and clinical function was evaluated by range of movement, Grace and Eversmann criteria measured at the last follow up. Results: Bony union was achieved in all patients. The mean time to bone union was 10.8 weeks in radius and 13.4 weeks in ulna. The average range of motion of forearm was 80.6° in supination and 83.2° in pronation. Both groups showed mean percentage of 97 compared with the contralateral side. Functional results assessed by Grace and Eversmann criteria were rated excellent in 11 cases and good in 6 cases. Conclusion: In our series, MIPO technique for comminuted one bone fractures in forearm shaft fracture was safe and effective, which had advantages, including a small skin incision, in bone biology.

Postoperative Complications of Minimally Invasive Plate Osteosynthesis (MIPO) for Distal Tibial Metaphyseal Fractures

The minimally invasive plate osteosynthesis (MIPO) technique is a widely used surgical option for treating distal tibial methphyseal fractures. The purpose of this study was to analyze results of the MIPO technique for distal tibial metaphyseal fractures and postoperative complications. Sixty-one patients with distal tibial metaphyseal fractures were included. They were followed for more than 12 months. Mean age was 53.1 years (range, 18-85 years). Males were 27 cases and females were 34 cases. Fractures were classified according to the AO/OTA classification system. Postoperative complications, radiological results, and clinical results were analyzed. The mean follow-up period was 61.9 months (range, 12-103). According to the AO/OTA classification, 11 cases were A1, 16 were A2, 18 were A3, 10 were B1, and 6 were B2. The mean time to bony union was 13.8 weeks (range, 12-24 weeks). Seven postoperative complications occurred in six patients including two infections, three overlying skin necrosis, and two nonunions. Fiftysix patients (91.8%) had excellent and good results and five (8.2%) had fair results. The MIPO technique was an effective surgical option for distal tibial metaphyseal fractures that produced good clinical and radiological results. Although the MIPO technique has many advantages, care should be taken for possible postoperative complications that may require additional surgery.

Minimally invasive plate osteosynthesis for distal femur fractures.

Many methods have been applied to manage the distal femur fractures. Minimally invasive plate osteosynthesis (MIPO) is the latest technology using locking compression plate (LCP) is the new concept for the management of these fractures. Total of 29 cases of the distal femur fractures ( 21 AO type 33A and eight AO type 33C) were treated with the MIPO technique. Clinical and radiological evaluation was done at 6, 10, 14, 20, 24 weeks and 9, 12, 18, 24 and 30 months respectively.The mean age of the patients was 44.96 years (range 20 -70); male patients were 18 and female were 11. The mean follow-up time was 36.62 months (range, 30 - 42 months). The patients were evaluated using Knee Society scores and the mean score was 90.24 (range, 75 – 100); the mean full weight bearing time was 15.41 weeks (range, 11 - 20 ) and union time was 22.55 weeks(range, 15 - 28). Superficial infections and slight mal-alignment were seen on five patients each. The MIPO with LCP technique can be used successfully to treat complex distal femur fractures with minimal complications. It can be an alternative method for the treatment of the distal femur fractures.

Fracturas periprotésicas de fémur en artroplastia total de rodilla: experiencia con técnica mínimamente invasiva

BackgroundPeri-prosthetic fracture of the distal femur above total knee arthroplasty presents a challenging surgical problem for orthopaedic surgeons, as complication rates for both surgical and non-surgical treatment have been reported to be as high as 30%.The minimally invasive plate osteosynthesis (MIPO) technique seems to have better results than other techniques in this type of fracture when there is no loosening of the femoral implant. MethodsA total of 32 patients with this fracture were treated from January 2005 to December 2011. A retrospective review was conducted on the weeks of consolidation, range of motion, final alignment, and the ability to walk. The mean follow up was 56.5 months (25-144). ResultsA total of 32 (31 female, 1 male) patients, with a mean age 77 (70-89) years old were treated, of whom 3 (9%) died and 4 were lost to follow-up.The mean time of consolidation was 16.5 weeks (8-24). There were no infections, although there were 3 non-unions and 1 malalignment (15° of valgus). We were able to restore the range of motion in every patient as it was before the fracture, as well as the ability to walk outdoors in 24 patients. ConclusionThe MIPO technique is a great technique in order to achieve a good range of motion and alignment of these fractures.Level of evidence IV.

The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

ObjectiveTo investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures. MethodsWe did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthe-sis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3). ResultsNo complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. ConclusionUsing LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.

Minimally invasive plate osteosynthesis of acetabular anterior column fractures using the two-incision minimally invasive approach and a preshaped three dimension plate.

To investigate the treatment of acetabular anterior column fractures using a two-incision minimally invasive (TIMI) approach and minimally invasive plate osteosynthesis (MIPO) technique using a preshaped 3D plate. A group of 12 consecutive cases of acetabular fractures from March 2013 to July 2014 were treated with the TIMI approach. 3D mirror models of the uninjured side of the hemipelvis were printed preoperatively; the plates used in surgery were preshaped according to these models. MIPO surgical techniques were applied. All patients had a minimum one year radiographic and clinical follow-up. Seven fractures involved the anterior column, four were anterior column with posterior hemitransverse, and one was anterior column with the pubic symphysis. The average surgery time was 200minutes, and mean blood loss was 1004ml. The fracture reduction results as assessed by Matta radiographic outcome scores were good in eight, satisfactory in three, and poor in one patient. Functional outcomes according to the Harris hip scores were excellent for seven, good for three, and fair for two. Post-operative complications included incomplete femoral nerve damage and abdominal cavity injury. The TIMI approach is an alternative to the ilioinguinal approach for anterior column acetabular fracture treatment, especially for fractures involving the dome and quadrilateral plate that are feasible for application of MIPO techniques. The technique of preshaping the 3D plate makes the plate better accommodated to the fracture surface and easier to apply in MIPO procedures. All dissection was between the anatomical interval, which allowed less soft tissue injury and related complications, and caused less bleeding. The fracture types in our case series were relatively simple, and follow-up time was short; more clinical trials are necessary for evaluation of middle- and late-term results.

Minimally invasive plate osteosynthesis in the treatment of proximal humeral shaft fractures

Introduction The treatment for proximal humeral shaft fracture is still controversial, attributed to the multiplicity of treatment options. The aim of this study was to evaluate the results of minimally invasive plate osteosynthesis (MIPO) in the treatment of proximal humeral shaft fractures. Patients and methods Between February 2007 and November 2011, 20 patients with displaced fracture of the proximal one-third shaft of the humerus were treated using the MIPO technique. The average age of the patients was 45.3 years, and there were 13 male and seven female patients. Eleven (55%) patients had AO (AO Foundation is a medically guided, not-for-profit organization led by an international group of surgeons specialized in the treatment of trauma and disorders of the musculoskeletal system) type 12C fractures. The right humerus was fractured in 11 (55%) patients. Falls were the most common cause of fracture in eight (40%) patients. Follow-up was carried out regularly with radiography and measurement of range of movement of the elbow. Results All fractures healed in an average time of 10.35 weeks within an average follow-up of 23.46 months. Surgery was performed on average 1.75 days after injury. Fractures were fixed using dynamic compression plating in 12 cases and locked plating in eight cases. The average range of elbow range of motion was 123 degrees; 12 (60%) patients were able to achieve full elbow extension at last follow-up. The average extension lag was 5.25°. The average range of elbow flexion was 128.25°. Six complications occurred in our cases. There were two cases of shoulder impingement. One patient developed deep infection. Three (15%) patients had postoperative radial nerve injuries. All of them recovered spontaneously. Conclusion Although MIPO is technically demanding, it is a safe and efficient procedure for the treatment of humeral shaft fracture. Adequate healing and low complication rate can be obtained if the appropriate surgical technique is used. Elbow flexion contracture can be regarded as a possible complication that can be avoided by the use of early adequate elbow rehabilitation protocol.

Minimal invasive fixation of distal tibial fractures does not result in rotational malalignment: A report of 24 cases with CT imaging.

Tibial torsion is rotation of the proximal versus the distal articular axis in the transverse plane. This study used computed tomography (CT) to examine rotational malalignment in the crus following use of minimally invasive plate osteosynthesis (MIPO) technique in distal tibial fractures and evaluated effect of rotational difference on clinical outcomes and VAS scores. Analysis of 24 patients who were operated on for closed distal tibial fracture with MIPO technique between 2010 and 2012 was conducted. Malrotation was defined as rotational difference >10°. Operated knees were evaluated with 0.5-mm, fine-cut, 3-dimensional CT scan performed in cooperation with radiology department. Side-to-side difference in tibial torsion angle >10° was considered significant degree of malrotation. All patients were assessed clinically (visual analogue scale [VAS] and American Orthopaedic Foot and Ankle Society [AOFAS] scores) and radiologically at final visit. Mean follow-up period was 20.00±9.46 months (range: 18-51 months). Mean VAS score was 2.58±0.83 (range: 1-4) and mean AOFAS score was 87.50±4.05 (range: 78-93). Mean tibial rotation angle was 31.54±6.00° (range: 18-45°) on healthy side and 32.00±6.24° (range: 10-43°) on the operated side. No statistically significant difference was determined (p>0.05). Use of intraoperative fluoroscopy, cable technique, and uninjured extremity as reference, can reduce incidence of rotational malalignment of distal tibial fractures treated with MIPO.

Minimally Invasive Plate Osteosynthesis with Locking Plates for Distal Tibia Fractures

Distal tibia fractures are challenging injuries with multiple fixation options. Minimal invasive plating for distal tibia fracture is becoming more popular with documented good outcomes. To evaluate the functional and radiological results of fixation of distal tibia fractures with locking plates with Minimally Invasive Plate Osteosynthesis (MIPO) technique. Fifty fractures of distal tibia without Intra-articular extension were operated with locking compression plating with MIPO technique. They were followed up at regular intervals. Functional and radiological results were evaluated at the end on one year. The fractures united in 48 (96%) patients with 2 (4%) cases of delayed union which took 30 weeks of time. Postoperatively, 2 patients developed superficial skin infection, 2 patients developed deep infection and 3 patients developed ankle stiffness due to loss of postoperative protocol and 4 patients had implant failure in form of screw breakage. Good amount of range of mobility of ankle joint was present in almost all patients. MIPO with locking plates for distal tibia fractures is associated with good functional outcomes and is an effective treatment for distal tibia fractures. Although, a larger sample of patients and longer follow up are required to fully evaluate this method of treatment, we strongly encourage its consideration in the treatment of such complex fractures.

Minimally invasive plate osteosynthesis in proximal humeral fractures: one-year results of a prospective multicenter study

The aim of this multicentric study was to evaluate results of minimally invasive plate osteosynthesis (MIPO) for proximal humeral fractures in terms of postoperative shoulder function, radiological outcome and number of complications. A consecutive series of 76 patients with proximal humeral fractures were treated with locking plate using a minimally invasive antero-lateral approach in two orthopaedic departments. Functional results with Constant score and radiographic evaluation were available for 74 patients at one-year follow up. The patients achieved a mean Constant score of 71 (range 28-100). Each functional result was evaluated also for both centres without significant differences. Significant statistical differences were only found for younger patients with better results (p < 0.05). Twenty patients (27%) developed complications. Subacromial impingement occurred in 16.2% of cases for varus malreduction (6.7%) and for too proximal plate positioning (9.5%). Primary screws perforation (2.7%), secondary perforation due to cut-out (1.4%), avascular necrosis (AVN) of humeral head (1.4%), partial resorption of greater tuberosity (2.7%), secondary dislocation of the greater tuberosity (2.7%) and stiffness (2.7%) were the other complications observed. The MIPO technique for proximal humeral fractures was safe and reproducible for most common patterns of fracture. Major complication rate was apparently low due to a soft tissue sparing, deltoid muscle and circumflex vessels, with easy access of the bar area to correct positioning of the plate.

Clinic research on the treatment for humeral shaft fracture with minimal invasive plate osteosynthesis: a retrospective study of 128 cases.

Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant-Murley score and HSS elbow joint score were used to evaluate the treatment outcome. The average duration of the surgery was 60min (range 40-95min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°-15° cubitus varus. After the average follow-up of 23 (13-38) months, satisfactory function was achieved according to Constant-Murley score and HSS elbow joint score. Constant-Murley score was 80 on average (range 68-91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique.

Does MIPO of fractures of the distal femur result in more rotational malalignment than ORIF? A retrospective study

Intraoperative control of rotational malalignment poses a big challenge for surgeons when using modern MIPO (minimally invasive plate osteosynthesis) techniques. We hypothesized that distal femoral fractures treated with MIPO technique are more often fixed in malrotation than those treated with open reduction internal fixation (ORIF). In this retrospective study, we identified 20 patients who met the inclusion criteria and agreed to take part in the study. In ten patients MIPO was applied, in the other ten ORIF was used. Mean age was 44.8 (19-71years). Functional status was assessed using clinical scores (Harris Hip Score, WOMAC Hip, KS Score, WOMAC Knee, Kujala Score). Rotational alignment was assessed with magnetic resonance imaging and compared to the opposite leg. We discovered a significant difference in the mean rotational difference between the MIPO group (14.3°) and the ORIF group (5.2°). Functionally, patients in the ORIF group outperformed patients in the MIPO group in all clinical scoring systems although no one proved to be statistically significant. MIPO technique was associated with significantly more rotational malalignment compared to ORIF in distal femur fracture fixation. However, implant failure and nonunion was more common in the ORIF group, with a revision rate of 3 versus 1 in the ORIF group. Clinical scoring did not significantly different between both groups. Taking into account the undisputable advantages of minimally invasive surgery, improved teaching of methods to avoid malrotation as well as regular postoperative investigations to detect any malrotation should be advocated.

Is minimally invasive plating osteosynthesis for humeral shaft fracture advantageous compared with the conventional open technique?

The minimally invasive plate osteosynthesis (MIPO) technique has been described and used effectively in humeral shaft fractures. However, the postoperative deformity resulting from malreduction with the minimally invasive technique has not received adequate attention. The purpose of this study was to evaluate the postoperative malrotation and the functional results of the MIPO technique and conventional plating in open reduction and internal fixation after humeral shaft fracture. A prospective cohort research was performed; 53 cases of humeral shaft fractures in a level I trauma center were included and allocated into group I for open reduction and internal fixation or group II for MIPO. Computed tomography was used to measure the postoperative malrotation. The status of the union, functional scoring, and muscle strength were recorded at 12 months after surgery. Both groups exhibited satisfactory union results and final shoulder function scoring. Shoulder girdle musculature of both groups exhibited considerable strength loss with no obvious intergroup discrepancy, with greater internal rotation strength loss compared with external rotation. A significantly increased incidence of postoperative malrotation >20° was observed in the MIPO group (40.9% vs. 0%; P < .01). A linear correlation between postoperative malrotation and range of rotation loss was observed. The MIPO technique might be advantageous as a cosmetic consideration; however, it did not improve postoperative function and strength restoration results more than the open technique. Moreover, MIPO was associated with greater postoperative malrotation, which was considered to be correlated with subsequent long-term shoulder degeneration.

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

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.