Pitfalls of Minimally Invasive Fracture Repair

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Key points

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    Minimally invasive fracture repair (MIFR) is the ultimate culmination of current osteosynthesis concepts that emphasize the preservation and enhancement of the biologic components of fracture healing.

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    Although the “less is more” approach to tissue dissection and fracture exposure and handling that defines MIFR has numerous reported advantages over more traditional open surgical treatments, it does present some unique challenges and important considerations for the surgeon.

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    This article describes

Planning

Perhaps one of the biggest differences between MIFR and original guidelines set forth by the Arbeitsgemeinschaft für Osteosynthesefragen (AO) group is the need for more extensive presurgical planning and awareness. The original AO goal of direct open surgical visualization of all fracture components to facilitate complete anatomic reconstruction requires less planning because little is left to the imagination. Less concern for hematoma preservation and minimizing soft tissue and bone fragment

The Basics

Excellent lighting may seem like a basic operating room necessity, but it is a particularly important requirement in MIFR cases. Visualizing implants and anatomy through small stab incisions requires more focused lighting than does an open approach. As such, I believe that a high-quality headlamp is a necessity for any surgeon preforming MIFR. In addition, having a supply of instruments to facilitate MIFR will greatly reduce hardships. An ample supply and assortment of different-sized

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