Minimally Invasive Plate Osteosynthesis ..
There is consensus in the world literature as regards the treatment of both intercapsular and extracapsular condylar fractures in children, which must be with closed treatment. When this type of opinion was challenged, some authors now admitted the possibility of using open reduction in cases of condylar fractures in children, provided that the technique was minimally invasive, as for example, by endoscopic surgery. Open reduction in children has recently been more accepted, mainly due to the development, confidence and greater experience of professionals with internal rigid fixation materials. Nevertheless, there is no consensus as regards the treatment of condylar fractures in adults. Among themselves, the authors agree that in adults, the type of treatment must mainly be chosen on a case by case basis and the personal experience of each professional.,,,,- There are 3 main treatments advocated for adults with condylar process fractures: 1) a period of maxillomandibular fixation (MMF) followed by functional therapy; 2) functional therapy without a period of MMF; and, 3) open reduction with or without internal fixation. Basic and very important requirements must be taken into consideration before the choice or option is made for the type of treatment in adult patients, such as: height and quantity of the fracture traces; uni- or bilateral fractures; total or partial loss of teeth; influence of the affected TMJ(s) on mandibular movements and the masticatory system; degree and direction of dislocation of the condyles; difficulty of surgical access; risk of lesion in critical anatomic structures; risk of hypertrophic and/or cheloid scar; patient's general health status; presence of other maxillofacial fractures; possibility of performing physical therapy; neuromuscular adaptations.,,,
03/12/2008 · AO Surgery Reference ..
Altman GT, Gallo RA, Molinero KG, Muffly MT, Mascarenhas L.. Minimally Invasive Plate Osteosynthesis for Proximal Humerus Fractures: Functional Results of Treatment. Allegheny General Hospital. Pittsburgh, PA. The American Journal of Orthopedics. 2011 Mar:40(3): E40-7.
The skin incision for minimally invasive plate osteosynthesis of a distalfemoral fracture is simply a shorter version of the open lateral approach tothe distal femur. As with the standard open lateral approach, the distal extentof the incision depends on the need for an arthrotomy. However, the proximalextent is shorter as the plate will be slid into a submuscular tunnel.
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Dr. Molinero is a board certified, fellowship trained orthopedic surgeon. Caring for patients across the entire spectrum of orthopedics, Dr. Molinero utilizes both nonsurgical and surgical treatments in order to provide exceptional healthcare and improve his patients’ quality of life. His vast experience includes treatment for varied forms of arthritis using joint preservation/replacement surgery, sports or age related injuries and tendon/ligament derangement using open/arthroscopic surgery, nerve disorders, and trauma/fractures. He utilizes PRP (platelet rich plasma) injections in the treatment of some disorders. He is fellowship trained in orthopaedic trauma surgery providing expert care of complex injuries to soft tissues, joints, and bones (fractures) using traditional and minimally invasive/biologic sparing methods of repair.
Kenneth Molinero, DO - The Orthopedic Group
A-0093 Long volar plating for metadiaphyseal fractures of distal radius: study comparing minimal invasive plate osteosynthesis (MIPO) versus conventional approach