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Minimally Invasive Plate Osteosynthesis at Bangkok Hospital

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Bangkok Hospital utilizes the Minimally Invasive Plate Osteosynthesis (MIPO) Technique

The Bangkok Fracture Center is available for treatment and consultation 24/7

Bangkok Hospital opened its Bangkok Fracture Center in order to provide a specialized and high standard of fracture care. This includes fractures that occur as a result of accidents, osteoporosis due to aging, retreatment of any abnormalities occurred from previous fracture treatment, as well as providing modern treatment methods such as the Minimally Invasive Plate Osteosynthesis (MIPO).

Dr. Suthorn Bavonratanavech, Senior Director of the Bangkok Orthopedic Center at Bangkok Hospital indicates that the number of fractures is rising and will continue to do so. This includes fractures due to accidents or incurred as a result of osteoporosis. Given that Thailand is an ageing society, cases of osteoporosis and thus osteoporosis related fractures, are expected to increase.

Bone and joint conditions are complex and as such orthopedic surgeons must undergo extensive training and look to continuously improve to ensure efficient treatment.

Dr. Suthorn Bavonratanavech is an expert orthopedic surgeon who is highly engaged in the international orthopedic community. In 2014, he had the honor of becoming the first Asian President of AO Foundation. The AO foundation is a non-profit medical research association established by Swiss Doctors in 1958 which focuses on effective fracture treatment practices. The AO has come to represent the premium standard for orthopedic surgery and has developed numerous techniques, which have spread from their origin in Europe, to the rest of the world.

Dr. Suthorn indicates that modern advancements in technique have led to more effective fracture treatment practices. The principles afforded by the AO include proper alignment of the fractured bone/bones, usage of special equipment to stabilize the bone/bones, and surgery that does not cause a large degree of damage to surrounding blood vessels and tissues, ensuring that patients will be able to move about more freely after treatment.

Furthermore, advancements such as Minimally Invasive Plate Osteosynthesis (MIPO) have helped to increase the success rate of surgical treatment whilst simultaneously reducing the chance of complications occurring during and after surgery. This new technique can also be applied to fractures that occur in any area of the body, from the collarbone through to the ankles and feet.

The Bangkok Orthopedic Center is a specialized in treatment of bone and joint conditions throughout body. It is staffed by a multidisciplinary team trained in Hand and Microsurgery, Pediatric Orthopedics, Bone Tumor, Foot and Ankle Conditions, and Ortho Trauma. It has also opened its very own Fracture Center, demonstrating the expertise available for patients  who needed consultation and treatment for fractures..  The Fracture Center utilizes advanced technology and medical equipment such as the C-arm and high quality Swiss implants, the application of which will depend on each individual patient’s needs and the type of fracture. A team is on hand 24/7 a day to handle emergency situations and to provide consultation as required.

Furthermore, the Fracture Center sees the importance of geriatric care for the elderly who suffer a hip fracture. Cares for these patients require specialization as they will often have a pre-existing condition such as cardiovascular disease, diabetes, and hypertension. Because of this, the Geriatric Hip Fracture Co Management Program was established to provide older patients with fast, accurate, and comprehensive treatment.

“Effective care and standardized treatment of fractures requires selection of appropriate technique. There are numerous methods, each of which has different advantages and limitations, as such it is a requirement that medical personnel are knowledgeable and specialized in each technique,” Dr. Sunthorn says.

Dr. Vajara Phiphobmongkoll Orthopedic Surgeon at the Bangkok Fracture Center indicates that “in cases of patients who suffer an automotive accident, apart from potential fractures there may be significant damage done to the periosteum (the thin layer of tissues which surrounds the outer layer of all bones), blood vessels, and muscle tissues around the injury area. This all contributes to pain and can cause reduced mobility for the patient. Techniques such as Minimally Invasive Plate Osteosynthesis (MIPO) help to reduce recovery period allowing patients to return to daily activities sooner. The method chosen for treatment of fractures will depend on the type and severity of the fracture. Modern treatment does not simply involve inserting a plate and realigning the broken bones, special attention is also given to Damage Control and Polytrauma”.

The Minimally Invasive Plate Osteosynthesis (MIPO) has become ever more popular in treatment of fractures. This technique involves a small incision above the fracture site, and utilizes specialized equipment to insert a metal plate to be held in place with screws above and below the area. The goal is to cause as little damage to surrounding tissues as possible, for enhanced accuracy the doctor will use a fluoroscope X-ray to ensure proper alignment. The incision made in Minimally Invasive plate Osteosynthesis (MIPO) is far smaller, which results in less bruising, allowing for a faster recovery period, and less chance of complications such as infection or the need for repeat surgery.

Dr. Vajara reminds us that fractures do not only occur from accidents, but can also be caused by other factors such as osteoporosis. For example, minor injuries or falls can lead to serious complications such as hip fractures. In the case of hip fracture, the bone will be unable to mend itself simply through rest. Furthermore cases occurring in older patients will usually be accompanied by several possible complications, such as bed sores as a result of lying still for a prolonged period of time, or pneumonia that can lead to death. Osteoporosis also affects the spine, causing chronic back pain and shortened height (spine). As such, prompt diagnosis is pivotal to taking preventative action as well as influencing treatment decisions for various orthopedic conditions.  

“The medical team’s expertise must be able to recognize the sensitivity and diversity of bones of people of different ages, especially those of older patients (who are necessarily more fragile than other age groups) is important.  Programs such as the Geriatric Hip Fracture Co Management Program help to ensure that all processes and treatment with regards to Minimally Invasive Plate Osteosynthesis are effective and that patients will be able to return to a good quality of life”.

Selection of treatment method will depend largely on the attending physician, who will make the choice of which treatment to use, not necessarily surgical. However, once there are clear indicators for the need of surgical treatment, it is important to ensure all processes and equipment adhere to international standards, to reduce or even prevent negative outcomes for the patient.

The Bangkok Fracture Center at Bangkok Hospital offers a team of specialized multidisciplinary orthopediatricians supported by advanced medical technology. The center offers consultation for patients before and after treatment. A detailed treatment plan will be drawn up that will include selection of high quality implants from Switzerland. Patients will also be able to increase their knowledge about prevention and treatment of conditions in daily life, from a standardized source.

The Fast Track Fracture Call Center is available 24 hours a day and can be contacted by calling 02-310-3000 or emailing BFC@bgh.co.th