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Minimal-invasive, ballonassistierte Aufrichtung und innere Fixation von Tibiaplateaufrakturen

Minimally invasive balloon-assisted reduction and internal fixation of tibial plateau fractures

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Zusammenfassung

Aufgrund der häufig insuffizienten Weichteilsituation im Rahmen von Tibiaplateaufrakturen und der damit assoziierten höheren Rate an postoperativen Wundheilungsstörungen und Weichteilinfektionen ist ihre operative Behandlung nicht selten eine herausfordernde Aufgabe. Die klassische offene Reposition und Plattenosteosynthese beinhaltet eine ausgiebige Weichteilpräparation und partielle Periostablösung, um so die abgesunkenen Fragmente zu bergen und aufzurichten. Die Wiederherstellung der Gelenkfläche gestaltet sich dabei häufig als schwierig. In der vorliegenden Arbeit beschreiben wir eine neuartige operative Technik, in der das eingesunkene Tibiaplateau durch einen perkutan eingebrachten Ballon in Kombination mit einer minimal-invasiven Plattenosteosynthese versorgt wird. Darüber hinaus berichten wir über 5 Fälle, welche mit diesem Verfahren bislang behandelt wurden.

Abstract

The management of tibial plateau fractures can be challenging because of the scarcity of soft tissue associated with a high rate of wound healing disorders. Classic open reduction and internal plate fixation require extensive soft tissue dissection and periosteal stripping, and elevation of depressed fragments and maintenance of the reduction is difficult. In the current report the authors describe a novel operative approach to percutaneously reduce depressed tibial plateau fractures using an inflatable balloon in combination with minimally invasive plate fixation. The results of the first 5 cases treated with this technique are reported.

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  1. Klinik für Unfallchirurgie, Universitätsspital Zürich, Rämistraße 100, CH-8091, Zürich, Schweiz

    C.M.L. Werner M.L., M.J. Scheyerer, J. Schmitt, G.A. Wanner & H.-P. Simmen

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  1. C.M.L. Werner M.L.
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  2. M.J. Scheyerer
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  3. J. Schmitt
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  4. G.A. Wanner
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  5. H.-P. Simmen
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Correspondence to C.M.L. Werner M.L..

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C.M.L. Werner und M.J. Scheyerer haben zu gleichen Teilen zu dieser Arbeit beigetragen.

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Werner, C., Scheyerer, M., Schmitt, J. et al. Minimal-invasive, ballonassistierte Aufrichtung und innere Fixation von Tibiaplateaufrakturen. Unfallchirurg 115, 1126–1132 (2012). https://doi.org/10.1007/s00113-012-2245-5

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