Minimally Invasive Plate Osteosynthesis in the Elderly Patient

Minimally invasive plate ostesynthesis (MIPO) is not just a technique, it is a method of treatment for metadiaphyseal fractures that has three elements: small incisions, indirect functional reduction and flexible fixation. In an elderly patient, the osteoporotic fracture doesn't accept absolute stability well, because the bone cannot withstand interfragmentary compression. MIPO is a biologically friendly approach, preserving the blood supply of the soft tissues and the bone, allowing a better healing process, and less risk of non-union and infection. These are important factors in elderly patients because they are more likely to develop delayed healing and non-union, as well as infection due to deficiency of the immune system. This article presents the best way to reduce the fracture and place the plate in the bone to achieve the best construct. An angular, stable plate with a screw locking feature has brought mechanical and biological advantages to MIPO fixation. Clinical results are presented for the humeral, femoral and tibial fractures.