Animals 2024, 14(9), 1381

Minimally Invasive Plate Osteosynthesis (MIPO) of Comminuted Radial Fractures Using a Locking Plate Contoured on a 3D-Printed Model of the Feline Antebrachium: A Cadaveric Study

Piotr Tr?bacz, Jan Frymus, Mateusz Pawlik, Anna Barteczko, Aleksandra Kurkowska and Micha? Czopowicz

Three-dimensional printing turns a digital model in a computer file into a physical interpretation of the object. This technology is promising in both human and veterinary medicine, enabling the production of anatomical models, customized surgical instruments, implants, and prostheses. Minimally invasive plate osteosynthesis (MIPO) techniques have been developed to accelerate fracture healing by preserving soft tissue as well as the environment at the fracture site. Achieving acceptable alignment with MIPO can be challenging, because fractures are typically reduced indirectly and implants are inserted submuscularly, starting at one end of the broken bone. In our study, we presented results of comminuted feline radial fracture repair using MIPO with locking bone plates as a reduction tool. The implants were pre-contoured on 3D-printed bone models of the antebrachium of an adult male and a female domestic shorthair cat. A pre-contoured bone plate is a valuable tool for fracture reduction in MIPO.

Abstract

Background:

Due to the unique structural and functional characteristics of the forelimb in cats, fractures of the radius and ulna are best repaired using internal fixation and stabilization in accordance with AO principles. This study presents the results of reduction of 42 cadaveric comminuted feline radial fractures reduced by minimally invasive plate osteosynthesis (MIPO).

Methods:

Radius fractures were created on 21 pairs of forelimbs with intact bones. MIPO was then performed using two locking bone plates pre-contoured on 3D-printed bone models of the antebrachium of a male and a female cat. Pre- and postoperative radiographs were taken, and radius length and anatomical lateral distal radial angle (aLDRA) were measured.

Results:

All fractures were classified as complex diaphyseal fractures of the radius. The radial bone length did not change significantly after surgery (F1,18 = 0.01, p = 0.933). However, the aLDRA was modified after surgery (F1,18 = 7.51, p = 0.013), but this change was only observed in females, in whom the aLDRA was significantly reduced (p = 0.035) compared to the value determined by the shape of the plate. In males, the pre- and postoperative aLDRA values were similar (p = 0.824). In 40 cases, alignment, adjacency of bone fragments, and apparatus were judged to be satisfactory. In two cases, the plate was fixed to the proximal radius and distal ulna due to misidentification of the distal radius. In both cases, revision surgery and correct fixation of the radius gave proper alignment, adjacency, and apparatus.

Conclusion:

A pre-contoured plate on a 3D-printed model of the male and female domestic cat antebrachium was suitable for the reduction and stabilization of comminuted radial fractures in a cohort of domestic cat cadavers without the need to print individual antebrachial bone models for each patient.

#MIPO #orthopaedics #surgery #3DPrinting #VeterinaryEngineering

Full-text:

https://www.researchgate.net/publication/380324198_Minimally_Invasive_Plate_Osteosynthesis_MIPO_of_Comminuted_Radial_Fractures_Using_a_Locking_Plate_Contoured_on_a_3D-Printed_Model_of_the_Feline_Antebrachium_A_Cadaveric_Study