Surgical Approaches for Minimally Invasive Interlocking Nailing Osteosynthesis (MINO) in Dogs

Introduction: Studies have shown motivating results considering bone union and reduced number of complications. Intramedullary interlocking nail-shave mechanical and biological advantages when compared with bone plates, such as a greater preservation of extra bone vascularization and positioning on neutral mechanical axis.

Materials and Methods: Anatomical dissections were performed in 10 cadavers of dogs (30–40 kg). After dissection, the limbs were used to describe the MINO approaches (portals).

Results: Humerus: a craniolateral approach is used. The anatomical point used as a reference for introduction of the intramedullary nail is the major tubercle. The distal portal should be made cranially to the lateral epicondyle. Femur: the cranial portal is made using a lateral approach to the great trochanter, extended to its dorsal portion, allowing access to the intertrochanteric fossa, where the nail will be inserted. The distal portal is cranially to the patella. Tibia: Medial approach is recommended. Incision is performed in the proximal aspect, near the tibial tuberosity, extended dorsally with opening of the knee joint. The drilling point for normograde implantation the nail is near the medial border of the tibial plateau and slightly medially and caudally angled.

Discussion/Conclusion: Describing the surgical approaches, and main anatomical points of reference for minimally invasive application of interlocking nails is very relevant.

Acknowledgment: CAPES funding agency.