Tuberoplasty: Minimally invasive osteosynthesis technique for tibial plateau fractures

Abstract

Fractures of the tibial plateau are in constant progression. They affect an elderly population suffering from a number of comorbidities, but also a young population increasingly practicing high-risk sports and using two-wheeled vehicles. The objective of this study was therefore to propose a new technique for the treatment of this type of fracture. There are a variety of classical pitfalls of conservative treatment such as defective reduction resulting in early osteoarthritis and alignment defects. Conventional treatments lead to joint stiffness and amyotrophy of the quadriceps, caused by the open technique and late loading. We propose an osteosynthesis technique for tibial plateau fractures with minimally invasive surgery. A minimally invasive technique would be more appropriate to remedy all of the surgical drawbacks resulting from current practices. The surgical technique that we propose uses a balloon allowing progressive and total reduction, associated with percutaneous screw fixation and filling with polymethylmethacrylate (PMMA) cement. The advantages are optimal reduction, minimal devascularization, soft tissues kept intact, as well as early loading and mobilization. This simple technique seems to be a good alternative to conventional treatment. The most comminuted fractures as well as the most posterior compressions can be treated, while causing the least impairment possible. Arthroscopy can be used to verify fracture reduction and cement leakage. At the same time, it can be used to assess the associated meniscal lesions and to repair them if necessary.

Anterolateral tibial plateau osteotomy as a new approach for the treatment of posterolateral tibial plateau fracture

“…The Balloon technique has also proved useful for the reduction of PL fragments, providing good outcomes and no complications. [ 15 , 16 ] The Balloon technique is particularly effective for acute compression fractures, but may be less efficacious for chronic (>3-month old) osteoporotic, traumatic, or pathologic compression fractures.…”

Characterization of bone fragment displacement during minimally invasive surgical procedures by digital volume correlation (DVC)

“…For several years, in traumatic surgery, techniques have evolved towards minimally invasive methods. In 2013, Vendeuvre et al published a new minimally invasive technic, named Tuberoplasty, to treat Schatzker type II fractures (Vendeuvre et al 2013) (Kfuri and Schatzker 2018). This type of fracture corresponds to the splitting and depression of the lateral tibial plateau and mostly occurs in fall from height cases.…”

“…The aim of this study is to show the interest of Digital Volume Correlation (DVC) to characterize the volume displacement of bone fragments during minimally invasive using the example of Tuberoplasty (Vendeuvre et al 2013) 2. Methods…”

Finite element analysis of mechanical behavior of stabilization techniques for tibial plateau fractures

“…Tibial plateau fracture treatment is carried out in most cases by stable fixation in order to allow early mobilization. Minimally invasive technologies such as tibioplasty or stabilization by locking plate augmentation are used to treat tibial plateau fractures (Vendeuvre et al 2013). This work deals with a numerical approach with a personalized finite element (FE) analysis, to determine the mechanical behaviour of the fractured tibial plateau stabilisation.…”