Minimally invasive percutaneous medial plate‐rod osteosynthesis for treatment of humeral shaft fractures in dog and cats: Surgical technique and prospective evaluation

• Published in: Veterinary surgery Vol. 48; no. S1; pp. O41 - O51
• Main Authors: Guiot, Laurent P., Guillou, Reunan P., Déjardin, Loïc M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-06-2019
• Subjects: Alignment; Animals; Biocompatibility; Body Weight; Bone Plates - veterinary; Cat Diseases - surgery; Cats; Complications; Compression; Configurations; Dog Diseases - surgery; Dogs; Female; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - veterinary; Fractures; Humans; Humeral Fractures - surgery; Humerus; Humerus - surgery; Locking; Male; Minimally Invasive Surgical Procedures - instrumentation; Minimally Invasive Surgical Procedures - methods; Minimally Invasive Surgical Procedures - veterinary; Osteosynthesis; Postoperative Period; Prospective Studies; Reconstructive Surgical Procedures - instrumentation; Reconstructive Surgical Procedures - methods; Reconstructive Surgical Procedures - veterinary; Reduction; Treatment Outcome; Wound Healing
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13134

Objective
To describe and prospectively report outcomes associated with a novel minimally invasive percutaneous osteosynthesis (MIPO) technique for the treatment of humeral fractures in dogs and cats.
Study design
Prospective clinical case series.
Animals
Eleven dogs and 4 cats with traumatic nonarticular humeral fractures.
Methods
Dogs and cats that presented with traumatic humeral fractures were enrolled in the study. After closed reduction, the fracture was stabilized by using a plate‐rod combination applied via remote medial incisions. Postoperative alignment in the frontal and sagittal planes was statistically compared with the contralateral limbs. Time to clinical union and complications were also recorded.
Results
Eleven dogs and 4 cats were included in this study. Body weight ranged from 4.5 to 33.6 kg in dogs and from 2.2 to 3.6 kg in cats. A veterinary cuttable plate (6/11 dogs and 3/4 cats) or locking compression plate was used in a plate‐rod configuration (11/11 dogs and 2/4 cats) or alone (2/4 cats). Rod‐to‐medullary‐cavity ratio was 30%. Plate‐span ratio was 5.8 (range, 2‐13.5). No significant differences were found in frontal or sagittal plane alignment. Healing time in cases that completed on‐time follow‐up (12/15) was 36 ± 14 days (range, 20‐69). No major complications were recorded.
Conclusion
The reported technique was associated with good outcomes in a large variety of fracture configurations and animal sizes, with no complications.
Clinical significance
This report provides evidence that MIPO is a compelling alternative to open reduction and internal fixation in the treatment of various humeral fractures.