Minimally invasive plate osteosynthesis (MIPO) for scapular fractures

Oper Orthop Traumatol. 2023 Aug 18. doi: 10.1007/s00064-023-00819-5. Online ahead of print.ABSTRACTOBJECTIVE: Presentation of a minimally invasive surgical approach for the treatment of scapular fractures and the clinical outcome using this technique.INDICATIONS: Displaced extra-articular fractures of the scapula body and glenoid neck (AO 14B and 14F) and simple intra-articular fractures of the glenoid.CONTRAINDICATIONS: Complex intra-articular fractures and isolated fractures of the coracoid base.SURGICAL TECHNIQUE: Make a straight or slightly curved incision along the lateral margin of the scapula leaving the deltoid fascia intact. Identify the interval between the teres minor muscle and infraspinatus to visualize the lateral column, whilst retracting the deltoid to visualize the glenoid neck. Reduce and align the fracture using direct and indirect reduction tools. A second window on the medial border of the scapula can be made to aid reduction and/or to augment stability. Small (2.0-2.7 mm) plates in a 90° configuration on the lateral border and, if required, on the medial border are used. Intra-operative imaging confirms adequate reduction and extra-articular screw placement.POSTOPERATIVE MANAGEMENT: Direct postoperative free functional nonweight-bearing rehabilitation limited to 90° abduction for the first 6 weeks. Sling for comfort. Free range of motion and permissive weight-bearing after 6 weeks.RESULTS: We collected data from 35 patients treated with minimally invas...
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Source Type: research