Tibial Bone Grafting for Lateral Tibial Plateau Fractures

Abstract

Figure 1 shows the vascular clamp in position controlling the femoral artery. After the operation has been completed, the separate skin incisions can be utilised for placement of drains if required.The ability to tie a safe, secure knot is one the first and most fundamental skills that a surgeon learns. Traditional simulators that are used by trainee surgeons to practise knot tying are based around a fixed hook attached to a surface or attached inside of a cup to simulate knot tying down into the pelvis. It has been suggested that the more junior a trainee surgeon is the more force they apply to the structure being tied. In vivo, this can result in problems like vessel avulsion. This simple DIY technique allows a trainee surgeon to practise knot tying whilst also practising the skill of not applying too much force to the structure being suture ligated, something that can not be practised on a fixed hook simulator. An empty 330-ml drink can is needed. The ring pull is positioned upright as illustrated (Fig. 1). The can is placed on a piece of A4 paper and a circle drawn around the side of the can. The trainee then uses the ring pull to practise tying knots without moving the can outside of the circle or lifting the can from the surface. This provides for a cheap, simple and readily available training tool.Sources of bone graft for treating lateral tibial plateau fractures include iliac crest, distal femur and medial tibia. 1 We describe a technique whereby bone is taken from the lateral tibia itself thus avoiding donor site morbidity.

Arthroscopy Assisted Reduction Percutaneous Internal Fixation versus Open Reduction Internal Fixation for Low Energy Tibia Plateau Fractures

“…The anterior-lateral surgical approach is often used to reduce and internally fixate tibia plateau fractures, especially in lateral tibia plateau injuries 12,13 . Traditionally, the purpose of arthrotomy of the lateral knee joint compartment and elevation of meniscus from tibia plateau in Schatzker I to III fractures is to assess the effect of fractures reduction directly, decompression of the articulate surface is completed from the fracture gap or bony window in metaphyseal area 42–44 . With the development of arthroscopic technique, the reduction assessment could be achieved without arthrotomy, the fracture fixation could be completed in minimally invasive fashion 45–47 .…”

Incidence and pattern of technical complications in balloon-guided osteoplasty for depressed tibial plateau fractures: a pilot study in 20 consecutive patients

“…The main challenges consist of achieving anatomic joint reduction in conjunction with stable fracture fixation, to allow early range of motion of the knee, with the aim of achieving good functional outcomes [4]. Further limitations include the risk of a residual intra-articular step-off after insufficient articular reduction [5], and the adequacy of bone grafting options to fill the metaphyseal void after fracture reduction with conventional bone tamps [6-9]. Recent advances in technique include less-invasive approaches in conjunction with stable fixation using a new generation of angular-stable implants [10,11], and the appealing option of arthroscopy-guided fracture reduction and fixation [12,13].…”