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MIPO approach

Minimally invasive plate osteosynthesis (MIPO) approach to the distal femur from lateral/anterolateral

Distal approach

Lateral skin incision for minimally invasive plate osteosynthesis

The skin incision for minimally invasive plate osteosynthesis of a distal femoral fracture is simply a shorter version of the open lateral approach to the distal femur. As with the standard open lateral approach, the distal extent of the incision depends on the need for an arthrotomy. However, the proximal extent is shorter as the plate will be slid into a submuscular tunnel.

The proximal starting point for the skin incision is in the metaphyseal region of the femur.

The distal extension of the skin incision is dependent on whether or not an arthrotomy needs to be performed. If joint exposure is needed, the incision is carried to the level of the tibial tubercle (dashed line). If an arthrotomy is not necessary, the skin incision can stop approximately 1-2 cm distal to the joint line.