In the ever-changing field of medicine, newer inventions and techniques have enabled us to perform better and faster with each passing day. Whether it be the medicines or the implants we use, the focus is always on returning the patient to their pre-disease status at the earliest. In this aspect, mention must be made about the vast recent advances made in the field of Minimally Invasive Surgery (MIS). The objective of MIS is to perform complex and highly demanding surgeries through the smallest incisions possible thereby decreasing the immediate post-operative, as well as the long-term morbidity of the surgery significantly. Just like all other branches of modern surgery, trauma surgery too, has put MIS techniques to fruitful use.
Through the years, the AO Foundation for the treatment of fractures has shown the world the path to unfailing fracture healing concepts and fixation techniques. The techniques demonstrated by the foundation propagate the usage of certain special instrumentation through specifically crafted incisions which are often a part of conventional incisions used for fixation of the same fracture. The deeper fascial and muscular planes are separated or “lifted-off” through these same mini-incisions and bone is exposed sufficiently to introduce the implant inside. Radio-imaging is used to reduce the fracture as also to position the implant correctly. The other end of the implant is exposed through a similar incision. Once the adequacy of reduction and position of the implant are positively confirmed, the implant is fixed to the bone. Additional incisions are taken if necessary. There is thus an extremely restricted stripping of the soft tissues including the periosteum (which carries the major blood supply to the bone) and hence faster recovery with decreased risk of bone avascularity or necrosis.
Since the incision size, and thus the soft-tissue damage, is far lesser than the conventional incision, recovery is rapid and often the patient is able to mobilize out of bed the very next day after the surgery. Surgical pain is significantly less as is the period of full recovery. MIS techniques for Trauma thus promise a faster functional recovery and more cosmetic result even after major injuries, thus opening new aspects for better fracture care.
Dr. Prashant Pradeep Agarkar
Specialist Orthopaedic Surgeon
Aster Clinic, Al Nahda, Sharjah