Minimally invasive plate osteosynthesis: applications and techniques in dogs and cats

Bone plating has been used as a method of fracture management for many years. Recently, a trend toward the use of fracture fixation techniques which preserve the local fracture environment, known as biological osteosynthesis, has evolved. This trend has resulted in the development of a less traumatic method of bone plating referred to as minimally invasive plate osteosynthesis (MIPO), or percutaneous plating. During MIPO fracture stabilisation, plates are inserted through short incisions and a communicating epiperiosteal tunnel. Typically, bone plates applied in this fashion have a bridging function. Promising outcomes have been reported in human patients undergoing MIPO fracture stabilisation, and limited reports of the use of this technique in dogs and cats have yielded positive results as well. Careful case selection, pre-operative planning, and appropriate instrumentation are necessary when performing the technique. Rapid time to union, low complication rates and good return to function have been noted in human patients. Additional research is needed to define selection criteria and outline the definitive benefits of MIPO in dogs and cats.