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Published in: International Orthopaedics 9/2012

01-09-2012 | Original Paper

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

Authors: Philipp Ahrens, Gunther Sandmann, Jan Bauer, Benjamin König, Frank Martetschläger, Dirk Müller, Sebastian Siebenlist, Chlodwig Kirchhoff, Markus Neumaier, Peter Biberthaler, Ulrich Stöckle, Thomas Freude

Published in: International Orthopaedics | Issue 9/2012

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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.
Literature
1.
go back to reference Burri C, Bartzke G, Coldewey J, Muggler E (1979) Fractures of the tibial plateau. Clin Orthop Relat Res 138:84–93PubMed Burri C, Bartzke G, Coldewey J, Muggler E (1979) Fractures of the tibial plateau. Clin Orthop Relat Res 138:84–93PubMed
2.
go back to reference 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):707–711PubMed 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):707–711PubMed
3.
go back to reference Gordán F, Tóth K (1993) Experience with the surgical management of fractures of the tibial head. Magy Traumatol Ortop Kezseb Plasztikai Seb 36(4):305–311PubMed Gordán F, Tóth K (1993) Experience with the surgical management of fractures of the tibial head. Magy Traumatol Ortop Kezseb Plasztikai Seb 36(4):305–311PubMed
4.
go back to reference Caspari RB, Hutton PM, Whipple TL, Meyers JF (1985) The role of arthroscopy in the management of tibial plateau fractures. Arthroscopy 1(2):76–82PubMedCrossRef Caspari RB, Hutton PM, Whipple TL, Meyers JF (1985) The role of arthroscopy in the management of tibial plateau fractures. Arthroscopy 1(2):76–82PubMedCrossRef
5.
go back to reference Bauer J, Vanicky D, Klima M (1975) Conservative and surgical management of new tibial-head fractures. Hefte Unfallheilkd 126:245–246PubMed Bauer J, Vanicky D, Klima M (1975) Conservative and surgical management of new tibial-head fractures. Hefte Unfallheilkd 126:245–246PubMed
6.
go back to reference Krieg H, Chmielewski W, Sarvestani H (1975) Management of impression fractures of the tibial head using plate osteosynthesis. Hefte Unfallheilkd 126:256–257PubMed Krieg H, Chmielewski W, Sarvestani H (1975) Management of impression fractures of the tibial head using plate osteosynthesis. Hefte Unfallheilkd 126:256–257PubMed
7.
go back to reference Tscherne H, Lobenhoffer P (1993) Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res 292:87–100PubMed Tscherne H, Lobenhoffer P (1993) Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res 292:87–100PubMed
8.
go back to reference 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):263–267PubMedCrossRef 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):263–267PubMedCrossRef
9.
go back to reference 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):288–292PubMed 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):288–292PubMed
10.
go back to reference 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 456PubMedCrossRef 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 456PubMedCrossRef
11.
go back to reference Koval KJ, Helfet DL (1995) Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg 3(2):86–94PubMed Koval KJ, Helfet DL (1995) Tibial plateau fractures: evaluation and treatment. J Am Acad Orthop Surg 3(2):86–94PubMed
12.
go back to reference Berkson EM, Virkus WW (2006) High-energy tibial plateau fractures. J Am Acad Orthop Surg 14(1):20–31PubMed Berkson EM, Virkus WW (2006) High-energy tibial plateau fractures. J Am Acad Orthop Surg 14(1):20–31PubMed
13.
go back to reference Hsu CJ, Chang WN, Wong CY (2001) Surgical treatment of tibial plateau fracture in elderly patients. Arch Orthop Trauma Surg 121(1–2):67–70PubMedCrossRef Hsu CJ, Chang WN, Wong CY (2001) Surgical treatment of tibial plateau fracture in elderly patients. Arch Orthop Trauma Surg 121(1–2):67–70PubMedCrossRef
14.
go back to reference 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):50–56PubMedCrossRef 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):50–56PubMedCrossRef
15.
go back to reference 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):467–474PubMedCrossRef 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):467–474PubMedCrossRef
16.
go back to reference 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):273–281PubMedCrossRef 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):273–281PubMedCrossRef
17.
go back to reference 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):182–185PubMedCrossRef 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):182–185PubMedCrossRef
18.
go back to reference 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):359–364PubMedCrossRef 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):359–364PubMedCrossRef
19.
go back to reference König B, Khodadadyan C, Schäffler A, Pflugmacher R, Stöckle U (2007) Percutaneously navigated balloon fracture reduction in a displaced acetabular fracture. Unfallchirurg 110(12):1072–1075PubMedCrossRef König B, Khodadadyan C, Schäffler A, Pflugmacher R, Stöckle U (2007) Percutaneously navigated balloon fracture reduction in a displaced acetabular fracture. Unfallchirurg 110(12):1072–1075PubMedCrossRef
20.
go back to reference Heim KA, Sullivan C, Parekh SG (2008) Cuboid reduction and fixation using a kyphoplasty balloon: a case report. Foot Ankle Int 29(11):1154–1157PubMedCrossRef Heim KA, Sullivan C, Parekh SG (2008) Cuboid reduction and fixation using a kyphoplasty balloon: a case report. Foot Ankle Int 29(11):1154–1157PubMedCrossRef
21.
go back to reference 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):204–209PubMedCrossRef 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):204–209PubMedCrossRef
22.
go back to reference Bansal MR, Bhagat SB, Shukla DD (2009) Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients. Int Orthop 33(3):779–784PubMedCrossRef Bansal MR, Bhagat SB, Shukla DD (2009) Bovine cancellous xenograft in the treatment of tibial plateau fractures in elderly patients. Int Orthop 33(3):779–784PubMedCrossRef
23.
go back to reference 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):1127–1133PubMedCrossRef 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):1127–1133PubMedCrossRef
24.
go back to reference 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):231–235PubMedCrossRef 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):231–235PubMedCrossRef
Metadata
Title
Balloon osteoplasty—a new technique for reduction and stabilisation of impression fractures in the tibial plateau: A cadaver study and first clinical application
Authors
Philipp Ahrens
Gunther Sandmann
Jan Bauer
Benjamin König
Frank Martetschläger
Dirk Müller
Sebastian Siebenlist
Chlodwig Kirchhoff
Markus Neumaier
Peter Biberthaler
Ulrich Stöckle
Thomas Freude
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 9/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-012-1592-8

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