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Implantology of Fractures of the Proximal Tibia

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Handbook of Orthopaedic Trauma Implantology

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Abstract

Tibial plateau fractures are major injuries around the knee joint. The historical aspects of the evolution of various methods of surgically treating extra-articular and intra-articular fractures of the proximal tibia have been described in the present chapter. The biomechanical rationale for the choice of various implants has also been discussed. An overview has been provided about various implants that are available to the present-day surgeon for effectively managing tibial plateau fractures. The current preference for Schatzker I to IV is to place 3.5 mm anatomical plates and screws on the lateral and the medial tibial plateau compared to the 4.5 mm plates and screws because the 3.5 mm plates are more malleable, less bulky, have better anatomical fit, and give the option to place more number of screws in the subchondral bone. Placement of smaller diameter screws proximally is biomechanically superior to placing fewer larger diameter screws. Schatzker V and VI fractures are highly unstable and the implants used must be effective against various deforming forces. If single-column fixation is deemed sufficient then a single laterally placed 4.5/5.0 anatomical locking plate is the preferred choice. If dual plating is contemplated, a 3.5 mm locking plate on the lateral side and medial sides are preferred.

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Author information

Authors and Affiliations

  1. Department of Orthopaedics, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, India

    Karthik Vishwanathan

  2. Woodlands Multispeciality Hospital Limited, Kolkata, India

    Sudipta Ghosh

Authors
  1. Karthik Vishwanathan
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  2. Sudipta Ghosh
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Editor information

Editors and Affiliations

  1. NH Narayana Superspeciality and Multispeciality Hospitals, Howrah, West Bengal, India

    Arindam Banerjee

  2. Technical University of Munich, Munich, Germany

    Peter Biberthaler

  3. Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India

    Saseendar Shanmugasundaram

Section Editor information

  1. Columbia Asia Hospital, Kolkata, West Bengal, India

    Saumitra Misra

  2. Columbia Asia Hospital, Kolkata, West Bengal, India

    Rajiv Chatterjee

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Vishwanathan, K., Ghosh, S. (2023). Implantology of Fractures of the Proximal Tibia. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_82

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  • DOI: https://doi.org/10.1007/978-981-19-7540-0_82

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-7539-4

  • Online ISBN: 978-981-19-7540-0

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