Minimally invasive plate osteosynthesis without floating segment fixation for segmental fracture of femur.

Segmental fractures of the femur are technically difficult to manage by intramedullary nailing, the gold standard treatment. We specifically describe minimally invasive plate osteosynthesis (MIPO) without floating segment fixation for this particular fracture pattern. Twenty patients with segmental fractures of the femur were operated on by the MIPO technique. Data were collected on operative time, postoperative complications, union times, and clinical outcomes. The mean operative time was 63.5 minutes (range 50-90). There were no peri-operative complications. All fractures were united with a mean union time of 16.1 weeks (range 12-20). Regarding postoperative malalignment, limb shortening was demonstrated in 4 patients, valgus angulation in 2 and varus angulation in 3. One patient had a bent plate with 7°varus angulation. According to the Thoresen score, 13 were determined to be excellent values, 6 to be good and 1 to be fair. MIPO without floating segment fixation is a safe and effective alternative for segmental fractures of the femur especially in circumstances that are unsuitable or unfeasible for intramedullary nailing.