?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.title=Effect+of+surgical+approach+on+bone+vascularisation%2C+fracture+and+soft+tissue+healing+%3A+comparison+of+less+invasive+to+open+approach&rft.creator=Wullschleger%2C+Martin+Eduard&rft.subject=animal+model%2C+fracture+healing%2C+internal+fixator%2C+minimally+invasive+osteosynthesis%2C+minimally+invasive+plate+osteosynthesis%2C+multi-fragmentary+fracture%2C+ovine+model%2C+percutaneous+plating%2C+plate+osteosynthesis%2C+soft+tissue+trauma%2C+trauma+model&rft.description=Over+the+past+ten+years%2C+minimally+invasive+plate+osteosynthesis+(MIPO)+for+the+fixation+of+long+bone+fractures+has+become+a+clinically+accepted+method+with+good+outcomes%2C+when+compared+to+the+conventional+open+surgical+approach+(open+reduction+internal+fixation%2C+ORIF).+However%2C+while+MIPO+offers+some+advantages+over+ORIF%2C+it+also+has+some+significant+drawbacks%2C+such+as+a+more+demanding+surgical+technique+and+increased+radiation+exposure.+No+clinical+or+experimental+study+to+date+has+shown+a+difference+between+the+healing+outcomes+in+fractures+treated+with+the+two+surgical+approaches.+Therefore%2C+a+novel%2C+standardised+severe+trauma+model+in+sheep+has+been+developed+and+validated+in+this+project+to+examine+the+effect+of+the+two+surgical+approaches+on+soft+tissue+and+fracture+healing.%0D%0ATwenty+four+sheep+were+subjected+to+severe+soft+tissue+damage+and+a+complex+distal+femur+fracture.+The+fractures+were+initially+stabilised+with+an+external+fixator.+After+five+days+of+soft+tissue+recovery%2C+internal+fixation+with+a+plate+was+applied%2C+randomised+to+either+MIPO+or+ORIF.+Within+the+first+fourteen+days%2C+the+soft+tissue+damage+was+monitored+locally+with+a+compartment+pressure+sensor+and+systemically+by+blood+tests.+The+fracture+progress+was+assessed+fortnightly+by+x-rays.+The+sheep+were+sacrificed+in+two+groups+after+four+and+eight+weeks%2C+and+CT+scans+and+mechanical+testing+performed.%0D%0ASoft+tissue+monitoring+showed+significantly+higher+postoperative+Creatine+Kinase+and+Lactate+Dehydrogenase+values+in+the+ORIF+group+compared+to+MIPO.%0D%0AAfter+four+weeks%2C+the+torsional+stiffness+was+significantly+higher+in+the+MIPO+group+(p%3D0.018)+compared+to+the+ORIF+group.+The+torsional+strength+also+showed+increased+values+for+the+MIPO+technique+(p%3D0.11).+The+measured+total+mineralised+callus+volumes+were+slightly+higher+in+the+ORIF+group.+However%2C+a+newly+developed+morphological+callus+bridging+score+showed+significantly+higher+values+for+the+MIPO+technique+(p%3D0.007)%2C+with+a+high+correlation+to+the+mechanical+properties+(R2%3D0.79).%0D%0AAfter+eight+weeks%2C+the+same+trends+continued%2C+but+without+statistical+significance.%0D%0AIn+summary%2C+this+clinically+relevant+study%2C+using+the+newly+developed+severe+trauma+model+in+sheep%2C+clearly+demonstrates+that+the+minimally+invasive+technique+minimises+additional+soft+tissue+damage+and+improves+fracture+healing+in+the+early+stage+compared+to+the+open+surgical+approach+method.&rft.publisher=Queensland+University+of+Technology&rft.date=2010&rft.type=Thesis&rft.format=application%2Fpdf&rft.relation=https%3A%2F%2Feprints.qut.edu.au%2F38523%2F1%2FMartin_Wullschleger_Thesis.pdf&rft.rights=free_to_read&rft.relation=Wullschleger%2C+Martin+Eduard+(2010)+Effect+of+surgical+approach+on+bone+vascularisation%2C+fracture+and+soft+tissue+healing+%3A+comparison+of+less+invasive+to+open+approach.+PhD+thesis%2C+Queensland+University+of+Technology.&rft.id_number=https%3A%2F%2Feprints.qut.edu.au%2F38523%2F&rft.identifier=Faculty+of+Built+Environment+and+Engineering