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Balloon osteoplasty—a new technique for reduction and stabilisation of impression fractures in the tibial plateau: A cadaver study and first clinical application

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Abstract

Purpose

Fractures of the tibial plateau are among the most severe injuries of the knee joint and lead to advanced gonarthrosis if the reduction does not restore perfect joint congruency. Many different reduction techniques focusing on open surgical procedures have been described in the past. In this context we would like to introduce a novel technique which was first tested in a cadaver setup and has undergone its successful first clinical application.

Methods

Since kyphoplasty demonstrated effective ways of anatomical correction in spine fractures, we adapted the inflatable instruments and used the balloon technique to reduce depressed fragments of the tibial plateau.

Results

The technique enabled us to restore a congruent cartilage surface and bone reduction.

Conclusions

In this technique we see a useful new method to reduce depressed fractures of the tibial plateau with the advantages of low collateral damage as it is known from minimally invasive procedures.

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References

  1. Burri C, Bartzke G, Coldewey J, Muggler E (1979) Fractures of the tibial plateau. Clin Orthop Relat Res 138:84–93

    PubMed  Google Scholar 

  2. Boisrenoult P, Bricteux S, Beaufils P, Hardy P (2000) Screws versus screw-plate fixation of type 2 Schatzker fractures of the lateral tibial plateau. Cadaver biomechanical study. Arthroscopy French Society. Rev Chir Orthop Reparatrice Appar Mot 86(7):707–711

    PubMed  CAS  Google Scholar 

  3. Gordán F, Tóth K (1993) Experience with the surgical management of fractures of the tibial head. Magy Traumatol Ortop Kezseb Plasztikai Seb 36(4):305–311

    PubMed  Google Scholar 

  4. Caspari RB, Hutton PM, Whipple TL, Meyers JF (1985) The role of arthroscopy in the management of tibial plateau fractures. Arthroscopy 1(2):76–82

    Article  PubMed  CAS  Google Scholar 

  5. Bauer J, Vanicky D, Klima M (1975) Conservative and surgical management of new tibial-head fractures. Hefte Unfallheilkd 126:245–246

    PubMed  Google Scholar 

  6. Krieg H, Chmielewski W, Sarvestani H (1975) Management of impression fractures of the tibial head using plate osteosynthesis. Hefte Unfallheilkd 126:256–257

    PubMed  Google Scholar 

  7. Tscherne H, Lobenhoffer P (1993) Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res 292:87–100

    PubMed  Google Scholar 

  8. Cift H, Cetik O, Kalaycioglu B, Dirikoglu MH, Ozkan K, Eksioglu F (2010) Biomechanical comparison of plate-screw and screw fixation in medial tibial plateau fractures (Schatzker 4). A model study. Orthop Traumatol Surg Res 96(3):263–267

    Article  PubMed  CAS  Google Scholar 

  9. Duan XJ, Yang L, Guo L, Chen GX, Dai G (2008) Arthroscopically assisted treatment for Schatzker type I-V tibial plateau fractures. Chin J Traumatol 11(5):288–292

    PubMed  Google Scholar 

  10. Egol KA, Tejwani NC, Capla EL, Wolinsky PL, Koval KJ (2005) Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol. J Orthop Trauma 19(7):448–455, discussion 456

    Article  PubMed  Google Scholar 

  11. Koval KJ, Helfet DL (1995) Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg 3(2):86–94

    PubMed  Google Scholar 

  12. Berkson EM, Virkus WW (2006) High-energy tibial plateau fractures. J Am Acad Orthop Surg 14(1):20–31

    PubMed  Google Scholar 

  13. Hsu CJ, Chang WN, Wong CY (2001) Surgical treatment of tibial plateau fracture in elderly patients. Arch Orthop Trauma Surg 121(1–2):67–70

    Article  PubMed  CAS  Google Scholar 

  14. Gerich T, Blauth M, Witte F, Krettek C (2001) Osteosynthesis of fractures of the head of the tibia in advanced age. A matched-pair analysis. Unfallchirurg 104(1):50–56

    Article  PubMed  CAS  Google Scholar 

  15. Ballmer FT, Hertel R, Nötzli HP (2000) Treatment of tibial plateau fractures with small fragment internal fixation: a preliminary report. J Orthop Trauma 14(7):467–474

    Article  PubMed  CAS  Google Scholar 

  16. Holzach P, Matter P, Minter J (1994) Arthroscopically assisted treatment of lateral tibial plateau fractures in skiers: use of a cannulated reduction system. J Orthop Trauma 8(4):273–281

    Article  PubMed  CAS  Google Scholar 

  17. El Barbary H, Abdel Ghani H, Misbah H, Salem K (2005) Complex tibial plateau fractures treated with Ilizarov external fixator with or without minimal internal fixation. Int Orthop 29(3):182–185

    Article  PubMed  Google Scholar 

  18. Miki T, Wada J, Haraoka J, Inaba I (2004) Endoscopic transmaxillary reduction and balloon technique for blowout fractures of the orbital floor. Minim Invasive Neurosurg 47(6):359–364

    Article  PubMed  CAS  Google Scholar 

  19. König B, Khodadadyan C, Schäffler A, Pflugmacher R, Stöckle U (2007) Percutaneously navigated balloon fracture reduction in a displaced acetabular fracture. Unfallchirurg 110(12):1072–1075

    Article  PubMed  Google Scholar 

  20. Heim KA, Sullivan C, Parekh SG (2008) Cuboid reduction and fixation using a kyphoplasty balloon: a case report. Foot Ankle Int 29(11):1154–1157

    Article  PubMed  Google Scholar 

  21. Iida K, Sudo A, Ishiguro S (2010) Clinical and radiological results of calcium phosphate cement-assisted balloon osteoplasty for Colles’ fractures in osteoporotic senile female patients. J Orthop Sci 15(2):204–209

    Article  PubMed  CAS  Google Scholar 

  22. Bansal MR, Bhagat SB, Shukla DD (2009) Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients. Int Orthop 33(3):779–784

    Article  PubMed  CAS  Google Scholar 

  23. Yu B, Han K, Ma H, Zhang C, Su J, Zhao J, Li J, Bai Y, Tang H (2009) Treatment of tibial plateau fractures with high strength injectable calcium sulphate. Int Orthop 33(4):1127–1133

    Article  PubMed  Google Scholar 

  24. Patil S, Mahon A, Green S, McMurtry I, Port A (2006) A biomechanical study comparing a raft of 3.5 mm cortical screws with 6.5 mm cancellous screws in depressed tibial plateau fractures. Knee 13(3):231–235

    Article  PubMed  Google Scholar 

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Conflict of interest

We did not receive material funding from a third party. The authors declare that they have no conflict of interest.

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Correspondence to Philipp Ahrens.

Additional information

P. Ahrens and G. Sandmann have contributed equally to this study.

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Ahrens, P., Sandmann, G., Bauer, J. et al. Balloon osteoplasty—a new technique for reduction and stabilisation of impression fractures in the tibial plateau: A cadaver study and first clinical application. International Orthopaedics (SICOT) 36, 1937–1940 (2012). https://doi.org/10.1007/s00264-012-1592-8

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  • DOI: https://doi.org/10.1007/s00264-012-1592-8

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