Department of Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Vet Surg. 2021 Jul;50 Suppl 1(Suppl 1):O5-O16. doi: 10.1111/vsu.13685. Epub 2021 Jul 26.
To summarize and discuss peer-reviewed studies on minimally invasive osteosynthesis (MIO) of long bone, physeal, and articular fractures in dogs and cats.
Invited review.
A critique of literature was performed to assess MIO feasibility, outcomes, and complications through PubMed, Scopus, and CAB abstracts research databases (2000-2020).
More than 40 MIO articles have been published in the last 15 years, but most studies had small numbers, lacked control groups, and used limited outcome measures. Studies generally showed that MIO was feasible in dogs and cats with low complication rates. The current evidence does not demonstrate superior bone healing or functional outcomes with MIO when compared to standard methods. Although treatment principles, case selection, and techniques varied depending on the anatomical location, there were no salient differences in complication rates among long bones, physeal, and articular fractures treated by MIO.
The current available evidence and the personal experience of the authors support MIO as a promising fracture management modality. MIO can yield excellent outcomes when applied in carefully selected cases, performed by surgeons experienced in the technique. We cannot, however, conclude that MIO is superior to open fracture stabilization based on the available evidence in veterinary literature. Randomized controlled studies are warranted to prospectively compare MIO with other osteosynthesis techniques and thereby validate its role in fracture management for dogs and cats.
总结和讨论犬猫长骨、骺板和关节骨折微创接骨术(MIO)的同行评议研究。
特邀评论。
通过 PubMed、Scopus 和 CAB 摘要研究数据库(2000-2020 年)对文献进行评估,以评估 MIO 的可行性、结果和并发症。
在过去的 15 年中,已经发表了 40 多篇关于 MIO 的文章,但大多数研究的样本量较小,缺乏对照组,并且使用的结果评估方法有限。研究表明,MIO 在犬猫中是可行的,且并发症发生率较低。目前的证据表明,与传统方法相比,MIO 并不能提高骨愈合或功能结果。尽管治疗原则、病例选择和技术因解剖部位而异,但 MIO 治疗的长骨、骺板和关节骨折的并发症发生率并无明显差异。
目前的证据和作者的个人经验支持 MIO 作为一种有前途的骨折管理方式。在仔细选择的病例中,由经验丰富的外科医生进行 MIO 可以获得良好的结果。然而,我们不能根据兽医文献中的现有证据得出 MIO 优于开放性骨折稳定的结论。需要进行随机对照研究,以前瞻性地比较 MIO 与其他接骨技术,从而验证其在犬猫骨折管理中的作用。