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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2008 February;59(1):61-7
Surgical treatment of the injured: respecting the tissues
Lettich T., Parmar R., Parvizi J.
Department of Orthopedic Surgery Rothman Institute and Thomas Jefferson University Philadelphia, PA, USA
To treat severe fractures, over the past century orthopedic trauma surgeons have focused on altering their techniques to maximize the reduction and fixation while minimizing the surgical exposure required. Over the past decade, in particular, a few devices have been introduced, providing alternatives to traditional open techniques. One of these devices is the less-invasive stabilization system (LISS), which is indicated in fractures of the distal femur and proximal tibia. Another device is the percutaneous compression plate (PCCP) which is used to treat intertrochanteric fractures. This article aims to provide some information about these devices along with data supporting their continued use, and it also reviews a few techniques which have been developed to treat pelvic fractures of the iliac wings and sacroiliac joint. One of these techniques involves inserting a cannulated, self-locking, transiliac screw percutaneously through 2 small incisions over the sacral-iliac joints following initial reduction. For the patient, minimally invasive surgery offers a much smaller scar than traditional open procedures. For the surgeon one of the main appeals of minimally invasive fracture fixation is that by minimizing the surgical exposure, blood loss and surgical time can be drastically reduced, and thus the incidence of complications.