Erweiterter medialer und erweiterter lateraler Zugang bei Tibiakopffrakturen
Related Research units
Abstract
OBJECTIVE: Complete visualization of the articular surface in comminuted uni- or bicondylar tibial plateau fractures as a prerequisite for anatomical reconstruction to reduce the risk of posttraumatic osteoarthritis.
INDICATIONS: Unicondylar lateral or medial as well as bicondylar intra-articular tibial plateau fractures with central and/or dorsal fracture lines; comminuted destruction of the medial or lateral tibial plateau with dislocation of >2 mm.
CONTRAINDICATIONS: Critical soft tissue in the approach area, femoral condylar fracture, intraligamentous ruptures of the medial or lateral ligaments or the posterolateral corner.
SURGICAL TECHNIQUE: Medial: via the medial or anteromedial approach; lateral: via the antero- or posterolateral approach for open reduction and internal fixation of the tibial plateau fracture. Sharp dissection down to the medial/lateral ligamentous accompanying structures with subsequent presentation of the medial/lateral femoral epicondyle. Medial: approximately 2 × 2 cm osteotomy of the medial femoral epicondyle. Lateral: osteotomy of an approximately 1 × 1 × 0.5 cm bone block of the lateral femoral epicondyle either with protection or including the popliteus tendon running ventrally in the sulcus popliteus. In this case, a violation of the articular condyle should be avoided.
POSTOPERATIVE MANAGEMENT: Early functional posttreatment with full mobilization and 10-20 kg partial load bearing on forearm crutches, fracture-dependent for 6-12 weeks.
RESULTS: Very good visualization of the comminuted articular surface with postoperatively anatomical reconstruction of complex fracture patterns without postoperative concomitant instabilities.
Bibliographical data
Translated title of the contribution | Extended medial and extended lateral approach for tibial plateau fractures |
---|---|
Original language | German |
ISSN | 0934-6694 |
DOIs | |
Publication status | Published - 04.2019 |
PubMed | 30887093 |
---|