The safety and feasibility of minimally invasive plate osteosynthesis (MIPO) on the medial side of the femur: A cadaveric injection study

Injury
C Jiamton, T Apivatthakakul

Abstract

Minimally invasive plate osteosynthesis (MIPO) on the medial side of the femur appears to be a dangerous procedure due to possible femoral artery injury. This study aims to determine the feasibility of applying MIPO of the femur via the medial approach, and to determine the anatomical relationship and structures at risk between the artery and the implant using computed tomography angiography. A descriptive study of ten fresh cadavers was done. Two separate incisions were made, creating a submuscular tunnel close to the medial side of the femur. An 11- or 13-hole LCP lateral proximal tibial plate (5.0mm) was inserted through the distal incision into the submuscular tunnel and fixed. A CT angiogram with 3D reconstruction was made to determine the distance from and location of the plate relative to the femoral artery and surgical dissection was done to identify the structures at risk. No disruptions of superficial or deep femoral arteries were found. The closest distances from the superficial femoral artery and deep femoral artery to the plate were 8.3-27.2mm (average 16.3mm) (99% CI: 12.7-19.9) at the level 3 and 4.5-20.0mm (average 8.6mm) (99% CI: 6.4-10.9) at the level 2 in the proximal part of femur, respectively. The location...Continue Reading

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Citations

Dec 15, 2015·Injury·Theodoros H Tosounidis, Peter V Giannoudis
Dec 20, 2017·Journal of Orthopaedic Trauma·Andrew SwentikThomas Jones
May 4, 2017·EFORT Open Reviews·Josep Muñoz VivesTheodoros Tosounidis
Nov 11, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·A LangenbachStefan Schulz-Drost
May 12, 2018·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Dimitar TodorovKarl Stoffel
Nov 9, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Jed I Maslow, Cory A Collinge
Jan 27, 2018·Journal of Orthopaedic Trauma·Patrick F BerginGeorge V Russell
Oct 22, 2016·Journal of Orthopaedic Trauma·Norachart SirisreetreeruxErik A Hasenboehler
Sep 29, 2017·Archives of Orthopaedic and Trauma Surgery·Theerachai ApivatthakakulC Phornphutkul
Apr 2, 2020·The Bone & Joint Journal·Natalie C RollickDavid S Wellman
Jun 18, 2020·Operative Orthopädie und Traumatologie·Frank J P BeeresReto Babst
Jun 8, 2021·Archives of Orthopaedic and Trauma Surgery·Graham J DeKeyserJustin M Haller
Jul 7, 2021·Journal of Orthopaedic Trauma·Rafael Neiman, Christopher G Finkemeier

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