Susceptibility to local infection in biological internal fixation - Experimental study of open vs minimally invasive plate osteosynthesis in rabbits

Resistance to local infection alter fracture fixation with plate osteosynthesis may be influenced, by the implantation technique. It is known that the extent of the surgical approach to the bone can compromise the local defence capacity. We have investigated susceptibility to infection after a local bacterial challenge in rabbit tibiae using either the open surgical approach: for 'biological' internal fixation of standard 2.0 dynamic compression plates or the method of minimally invasive place osteosynthesis (MIPO), a percutaneous, tunnelling insertion technique preserving the Integrity of the overlying soft tissue. After the wounds had been closed, various concentrations of Staphylococcus aureus were injected in the direct vicinity of the implants, The infection rate for the open surgical technique was 38.5% and that for the MIPO technique, 25%. This difference is not statistically significant (P > 0.05) suggesting that resistance to local infection associated with the MIPO method is at least equivalent to the open approach for plate osteosynthesis.