Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

Rossi, Roberto; Castoldi, Filippo; Blonna, Davide; Marmotti, A.; Assom, Marco

doi:10.1016/j.arthro.2005.09.028

Cited by 22 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Within the four-month period no significant cartilage alterations were investigated; however, periimplant sclerosis, in particular next to or within the subchondral plate might, after a longer follow up, lead to consecutive cartilage damage. In this study design we simulated a conventional percutaneous proximal tibia osteosynthesis [34][35][36]. Instead of using two screws we only inserted one screw because of the following reason: As the size of the sheep knee is one third of the human knee the placement of a 3.5-mm diameter screw was chosen in this study to simulate similar conditions as in human proximal tibia osteosynthesis, where two times 6.5-mm screws are used.…”

Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Subchondral screw abutment in osteosynthesis of joint fractures is an effective method to achieve sufficient screw grip. In this study we investigated if subchondral screw placement is possible without harming the overlying subchondral plate and joint cartilage iatrogenic. Materials and Methods A 3.5-mm conventional steel screw was placed in the tibia of ten sheep in distances between 1 and 7 mm beneath the joint cartilage. After a follow up of two and four months, evaluation of the subchondral bone and joint cartilage was performed by means of a histological osteoarthritis score, HRpQCT imaging and determination of the glycosaminoglycan content in the cartilage. The control group was the contralateral knee of the same animal. Results Histomorphometric evaluation of the Mankin osteoarthritis score revealed no significant difference compared to the control after two (p = 0.102) and four months (p = 0.429).No correlation between distance of the screw to the cartilage and histological scoring was found (p = 0.658, R2 = 0.04 after two months and p = 0.171, R2 = 0.18 after four months). HRpQCT measurements of the subchondral thickness between screw and cartilage after two (p = 0.05) and four months (p = 0.424) showed no significant difference. Mean glycosaminoglycan content in the treatment group compared to the control after two months (p = 0.25) and four months (p = 0.523) was not significant different. Conclusion In conclusion subchondral screw abutment did not damage the joint cartilage after a two-and four-month follow up in this sheep model.

show abstract

Section: Discussionmentioning

confidence: 99%

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Goetzen

Hofmann‐Fliri

Arens

et al. 2017

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…1,2,31 The application of arthroscopy for treating certain articular fractures, such as tibial plateau or humeral glenoid fractures, has made it possible to decrease the risk of joint stiffness and complications associated with the open surgical approach. [32][33][34][35] Arthroscopy may offer the advantages of reduced pain and a more rapid, complete, and functional recovery. [35][36][37][38][39][40] Another benefit of arthroscopy-assisted fracture surgery is that a targeting device can be used to approach the depressed fragment and elevate and reduce the depressed articular surface.…”

Section: Discussionmentioning

confidence: 99%

Use of an aiming drill guide and ankle arthroscopy for reduction of depressed articular surface in posterior malleolar fractures

Lee

Kim

Park

et al. 2021

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Purpose We describe a novel technique that uses an aiming drill guide and ankle arthroscopy for direct visualization and reduction of the depressed articular surface located between the posterior tibia and the fractured posterior malleolus. This technique requires less soft tissue dissection to visualize and reduce the depressed articular surface. Methods Between June 2014 and May 2019, 126 patients were surgically treated for trimalleolar fractures. Among them, 11 had depressed articular fragment between the posterior tibia and the fractured posterior malleolus reduced using our novel technique. The study included six men and five women, with a mean age of 46.5 (range: 23–62) years. Results In eight (73%) cases, the articular surface was reduced, with the articular surface step-off being less than 2 mm, as noted on postoperative computed tomography (CT). Syndesmosis congruity within an anterior-to-posterior difference of less than 2 mm was confirmed in nine (82%) cases via postoperative CT. The mean 100-mm visual analog scale (VAS) and the mean Olerud-Molander ankle score at the final follow-up were 16.6 ± 14.5 and 87.7 ± 7.5, respectively. Conclusions The depressed articular fragment located between the posterior tibia and the fractured posterior malleolus can be treated using an aiming drill guide and ankle arthroscopy. Ankle arthroscopy is used for direct visualization of the depressed articular surface, and the aiming drill guide can guide the bone plunger precisely to the depressed articular surface for reduction. This technique requires less soft tissue dissection than conventional techniques to visualize and reduce the depressed articular surface.

show abstract

“…Locking plates are indicated for high-energy or comminuted bicondylar fractures and in osteoporotic injuries [ 25 - 28 ]. Arthroscopic-assisted reduction and fixation is mainly indicated for pure depression fractures [ 9 , 29 , 30 ], while external fixation can be valuable in complex cases with gross intra-articular comminution and severe soft tissue compromise [ 31 - 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most likely source of autograft for treating lateral tibial plateau fractures is the iliac crest [ 34 , 37 ]. Other sources of autograft for treating depressed lateral tibial plateau fractures include the medial tibia, the fibula, the patella and the greater trochanter [ 30 , 38 - 43 ]. The use of the distal femur has occasionally been referred as a bone graft donor site.…”

Section: Discussionmentioning

confidence: 99%

“…Younger and Chapman [ 44 ] reported three out of 239 patients (243 autogenous bone graft donor sites) but the exact graft harvest site is not clear. The use of the lateral femoral condyle as an alternative graft donor site for lateral tibial plateau fractures has previously been reported but without a bibliographical reference or a clinical study report [ 30 , 36 , 45 ]. Procurement of autogenous bone graft from the distal femur has also been reported in the treatment of acute trauma and reconstructive procedures [ 46 ], bone tumors [ 47 ] and patellar reconstruction [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures

Sferopoulos¹

2014

TOORTHJ

View full text Add to dashboard Cite

Introduction : The rationale for operative treatment of depressed tibial plateau fractures is anatomic reduction, stable fixation and grafting. Grafting options include autogenous bone graft or bone substitutes.Methods : The autograft group included 18 patients with depressed tibial plateau fractures treated with autogenous bone grafting from the ipsilateral femoral condyle following open reduction and internal fixation. According to Schatzker classification, there were 9 type II, 4 type III, 2 type IV and 3 type V lesions. The average time to union and the hospital charges were compared with the bone substitute group. The latter included 17 patients who had an excellent outcome following treatment of split and/or depressed lateral plateau fractures, using a similar surgical technique but grafting with bone substitutes (allografts).Results : Excellent clinical and radiological results were detected in the autograft group after an average follow-up of 28 months (range 12-37). The average time to union in the autograft group was 14 weeks (range 12-16), while in the bone substitute group it was 18 weeks (range 16-20). The mean total cost was 1276 Euros for the autograft group and 2978 Euros for the bone substitute group.Discussion : The use of autogenous graft from the ipsilateral femoral condyle following open reduction and internal fixation of depressed tibial plateau fractures provided enough bone to maintain the height of the tibial plateau and was not associated with any donor site morbidity. Using this method, the surgical time was not significantly elongated and the rehabilitation was not affected. It also exhibited faster fracture healing without postoperative loss of reduction and it was less expensive than the use of bone substitutes.

show abstract

Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

Cited by 22 publications

References 9 publications

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Subchondral screw abutment: does it harm the joint cartilage? An in vivo study on sheep tibiae

Use of an aiming drill guide and ankle arthroscopy for reduction of depressed articular surface in posterior malleolar fractures

Autograft Transfer from the Ipsilateral Femoral Condyle in Depressed Tibial Plateau Fractures

Contact Info

Product

Resources

About