Part I: Arthroscopic management of tibial plateau fractures

Lubowitz, James H.; Elson, Wylie S.; Guttmann, Dan

doi:10.1016/j.arthro.2004.09.001

Cited by 64 publications

(37 citation statements)

References 24 publications

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“…2,3,5,6 Several clinical studies have shown that the use of the arthroscope gives good results, offering such advantages as the evacuation of hemarthrosis and chondral debris, visualization of the anatomic reduction, a decreased morbidity, reducing hospitalization time, and postoperative care as well as the treatment of associated intra-articular injuries. [2][3][4]6,7 Standard practice for the management of the depression and split fractures (types I, II, III of Schatzker classification) of the external tibial plateau use grafts (allograftautograft-substitute-cement) and fixation to maintain the reduction. As a rule, the defect is filled with grafts, to improve articular reduction and decrease the risk of secondary relapse.…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

Rossi

Castoldi

Blonna

et al. 2006

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Abstract:We present a new technique for arthroscopic-assisted fluoroscopic treatment of external tibial plateau fractures (Schatzker type I, II, III), using custom-made instrumentation. The instrument includes 4 basic elements: 2 cutting guides, a hollow trephine cutter with a saw-toothed tip, and a bone plunger. The lateral plateau is restored from the opposite side. An anteromedial rectangular cortical window in the proximal diaphysis of the tibia is created using the cutting guides. To achieve the reduction, the hollow trephine cutter is introduced into the opening created. The bone plunger is inserted into the hollow trephine cutter until resistance is felt. At this point the cancellous bone is compacted by applying force onto the plunger with the hammer so as to obtain a strong compact bone carrot. The plunger then pushes it under the depressed area, filling it out and pushing it upward, creating an indirect reduction. The arthroscopy comes into play estimating the precise anatomic reduction of the articular surface of the tibia. No graft is necessary and cannulated lag screws fix and strengthen the reduction. This new technique is reproducible, easy, less invasive than others, and ensures a stable cartilage and subchondral support without the need for grafts.

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Section: Discussionmentioning

confidence: 99%

“…Several surgical techniques have been described with the goal of anatomic reduction, rigid internal fixation, and soft-tissue stability. [1][2][3][4] As does ours, most surgical techniques use arthroscopy, which guarantees an accurate diagnosis, provides an assessment of the joint, and follows the reduction, step by step.…”

mentioning

confidence: 93%

Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

Rossi

Castoldi

Blonna

et al. 2006

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Twentyfour patients were excluded from the study due to polytruama (8), spine injuries (6), tibial shaft fracture (6), and femoral shaft fracture (2) and unwilling to participate in the study …”

Section: Resultsmentioning

confidence: 99%

“…5,6 Unlike fall injury in elderly, motor vehicle accident produce fractures in young adults. 7,8 Schatzker classification system is patho-anatomical classification which guides to management of patient and is popular among surgeons. 9,10 Proximal tibia can withstand significant deformities unlike hip and ankle fracture; on that basis tibial plateau fractures were mostly treated by conservative methods in controlled traction, cast bracing and functional bracing paper till 1980.…”

mentioning

confidence: 99%

A study to evaluate the pattern and types of treatment of tibial plateau fracture at BPKIHS Dharan

et al. 2017

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“…Treatment goals that will lead to favorable results have been outlined as reestablishing the joint stability, alignment, and articular congruity that preserve full range of motion. 6 Open reduction and internal fixation have major risks such as wound dehiscence or infection. Direct visualization of the depressed articular surface is difficult in Schatzker type III fractures, even with a long anterior midline incision.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy

Ozkut

Poyanlı

Erçin

et al. 2017

Arthroscopy Techniques

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Accurate reduction and maintenance of the stability with correct implant positioning is critical for surgical treatment of tibial plateau fractures. Our technique includes an arthroscopic reduction and fixation of Schatzker type III tibial plateau fractures with a bulls-eye screw placement without fluoroscopy control. With the arthroscopic guidance, an anterior cruciate ligament drill guide is placed and a K-wire sent to the midpoint of the depressed fragment through the guide at a 40 angle to the coronal axis of the tibia. A tunnel is created with the drill over the K-wire. The depressed fragment is further augmented with gentle impacts over the K-wire. After arthroscopic reduction control, an appropriatesized iliac graft is pushed until it is below the depressed fragment. The targeting device is adjusted at 130 so that it is parallel to the joint line and a K-wire sent through the device so that it would pass just below the graft. The graft is then supported with cannulated screws sent over the K-wire. This technique provides an arthroscopic reduction of the chondral surface and precise placement of the rafting screws without fluoroscopy.L ong-term clinical results of tibial plate fractures are dependent on the quality of the intra-articular reduction of the articular surface. 1 Excessive dissection of the injured soft tissue envelope and devitalization of bone fragments are the primary concerns of the open techniques. To eliminate the problems related to the open techniques, many authors recommended minimally invasive reduction and stabilization techniques such as isolated lateral plating with medial external fixation, hybrid external fixation, tensionedwire fixation, and percutaneous reduction. [2][3][4] In Schatzker type III tibia plateau fractures, exploration of the fracture site is challenging because the lateral plateau is not displaced. Arthroscopic reduction and internal fixation are recommended as a safe and reliable method for treatment of tibia plateau fractures. 4 With arthroscopic-assisted techniques, the reduction of the depressed fragment can be performed indirectly without excessive dissection.Inherent advantages of arthroscopic-assisted techniques include less soft tissue stripping and lesser wound site complications. To avoid these complications, arthroscopic-assisted techniques that involve restoration of the depressed joint surface and grafting under the

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Part I: Arthroscopic management of tibial plateau fractures

Cited by 64 publications

References 24 publications

Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

Arthroscopic Treatment of Lateral Tibial Plateau Fractures: A Simple Technique

A study to evaluate the pattern and types of treatment of tibial plateau fracture at BPKIHS Dharan

Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy

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