Research Article| Volume 28, SUPPLEMENT 1, A13-A19, 1997

Minimally invasive plate fixation in femoral shaft fractures

      This paper is only available as a PDF. To read, Please Download here.


      Bridge-plating with its advantages in terms of vascularity and bone healing is a well established procedure today in the treatment of comminuted femoral fractures. Bridge-plating means that the fracture site is not interfered with during the operative procedure. This paper introduces a surgical technique in which the plate is inserted through isolated proximal and distal incisions only, behind the vastus lateralis. Alignment is secured by the plates, the fracture site remains untouched, fixation and screw insertion is restricted to the proximal and distal main fragments. Longitudinal femoral fractures extending right into the trochanteric and or condylar areas are the main indication for minimally invasive plate fixations with angled blade plates or condylar screws since fractures which are restricted to the diaphyseal area are mostly treated by nailing today. The surgical trauma resulting from plating by proximal and distal incisions only is less than that associated with conventional techniques. Indirect reduction of femoral fragments is much easier since the integrity of the surrounding muscles and soft tissue is preserved, the fragments often being reduced simply by traction. Adjustment of rotation is an essential aspect requiring careful attention. For special indications, namely comminuted fractures affecting a large part of the femur and extending into the trochanteric or condylar areas, insertion of the plate via proximal and distal incisions only is a further development in bridge-plating which minimizes surgical trauma and operation time.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Heitemeyer U.
        • Hierholzer G.
        • Terhorst J.
        Der Stellenwert der überbrückenden Plattenosteosynthese bei Mehrfragmentbruchschädigungen des Femurs im klinischen Vergleich.
        Unfallchirurg. 1986; 89: 533-538
        • Heitemeyer U.
        • Claes L.
        • Hierholzer G.
        Die Bedeutung der postoperativen Stabilität für die ossäre Reparation einer Mehrfragmentfraktur.
        Unfallchirurg. 1990; 93: 49-55
        • Baumgaertel F.
        • Perren S.M.
        • Rahn B.A.
        Tierexperimentelle Untersuchungen zur ‘biologischen’ Plattenosteosynthese von Mehrfragmentfrakturen des Femurs.
        Unfallchirurg. 1994; 97: 19-27
        • Tielemann F.W.
        • Blersch E.
        • Holz U.
        Die Plattenosteosynthese der Femurschaftfraktur unter Beachtung biologischer Gesichtspunkte.
        Unfallchirurg. 1988; 91: 389-394
        • Kinast C.
        • Bolhofner B.R.
        • Mast J.W.
        • Ganz R.
        Subtrochanteric fractures of the femur. Results of treatment with the 95° condylar blade-plate.
        Clin Orthop. 1989; 238: 122-130
        • Claudi B.F.
        • Oedekoven G.
        Biologische Osteosynthesen.
        Chirurg. 1991; 62: 367-377
        • Baumgaertel F.
        • Gotzen L.
        Die ‘biologische’ Plattenosteosynthese bei Mehrfragmentfrakturen des gelenknahen Femur. Eine prospektive Studie.
        Unfallchirurg. 1994; 97: 78-84
        • Tscherne H.
        • Trentz O.
        Operationstechnik and Ergebnisse bei Mehrfragment- and Trümmerbrüchen des Femurschaftes.
        Unfallheilkunde. 1977; 80: 221-230
        • Wenda K.
        • Degreif J.
        • Runkel M.
        • Ritter G.
        Zur Technik der Plattenosteosynthese des Femurs.
        Unfallchirurg. 1994; 97: 13-18
      1. Manual of internal fixation. Springer, Heidelberg1991
        • Krettek C.
        • Schandelmaier P.
        • Tscherne H.
        Distale Femurfrakturen.
        Unfallchirurg. 1996; 99: 2-10