Authors of section

Authors

Matthias Hansen, Rodrigo Pesantez

Executive Editors

Joseph Schatzker, Ernst Raaymakers, Rick Buckley

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Approach for minimally invasive osteosynthesis (MIO)

1. Principles

Articular reduction must be checked arthroscopically because the joint cannot be visualized directly through the small incision of a minimally invasive approach.

approach for minimally invasive osteosynthesis mio

2. Teaching video

AO teaching video: MIO Tibia, Proximal

Anterolateral Approach

3. Skin incision

Identify Gerdy’s tubercle. Make a straight incision about 5cm in length starting posteriorly to Gerdy’s tubercle and running distally and anteriorly.

mio angular stable plate liss
approach for minimally invasive osteosynthesis mio

4. Opening the fascia

Open the deep fascia starting at Gerdy’s tubercle and extend it distally. Expose the bone by releasing the anterior attachment of tibialis anterior.

approach for minimally invasive osteosynthesis mio

5. Arthroscopy

To control the articular reduction insert an arthroscope through a medial portal. You cannot make an adequate arthrotomy laterally through the small lateral incision of a minimally invasive approach.

approach for minimally invasive osteosynthesis mio

6. Wound closure

To avoid a compartment syndrome do not close the fascia. Close the soft tissues in a routine manner.