Development of a novel fracture fragment stabilization system for minimally invasive osteosynthesis and in vitro comparison to traditional Kern bone reduction forceps.

ABSTRACT

OBJECTIVE: To develop and evaluate a novel fracture fragment stabilization system, the Sirius minimally invasive bone reduction handle system (SMH), in an artificial fracture model (FxM) simulating a canine femoral fracture repair with a minimally invasive orthopedic approach. STUDY DESIGN: In vitro experimental study. SAMPLE POPULATION Synthetic fractured femurs with soft-tissue coverage analog (n = 8). METHODS: The developed SMH consisted of modified Kern forceps connected with existing external skeletal fixation components. Intramedullary Steinman pin placement with the SMH or traditional Kern forceps only (KO) was performed by 16 participants in randomized order. Demographics and surgical experience of participants and outcome variables (fragment movement, early/final gap formation, time of procedure, assessed practicability by visual analog scale) were recorded and statistically evaluated. RESULTS: The SMH was more difficult and took longer to assemble (P = .031 and P = .008); SMH resulted in a smaller final reduction gap (P = .008). More surgical experience resulted in faster surgery times (R2 = 0.766) but was not correlated with final fracture gap formation. CONCLUSION: The SMH was associated with reduced fragment gap formation in this simulated setting. CLINICAL SIGNIFICANCE: The SMH may be helpful for maintaining reduction of femoral fractures in dogs. Additional studies of the SMH should be conducted to fully assess the effectiveness and practicality in clinical cases.