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European Journal of Trauma and Emergency Surgery

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Open Access 09-12-2022 | Pityriasis Lichenoides Chronica | Original Article

Nanoscopy and an extended lateral approach can improve the management of latero-central segments in tibial plateau fractures: a cadaveric study

Authors: Peter Behrendt, M. T. Berninger, G. Thürig, J. Dehoust, J. Christensen, K.-H. Frosch, M. Krause, M. J. Hartel

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2023

Abstract

Introduction

The objective of this investigation was to compare different techniques to improve visualization and reduction in tibial plateau fractures involving the central lateral segments.

Methods

Matched pairs of pre-fractured cadaveric tibial plateau fractures that include the central lateral segments were treated by either an anterolateral approach (supine) or PL approach (prone). Reduction was stepwise extended by additional fracturoscopy (FS), nanoscopy (NS) and lastly by epicondyle osteotomy (ECO). Reduction was analyzed by 3D scan and visualization of the lateral plateau was quantified.

Results

Ten specimens (3 pairs 41B3.1, 2 pairs 41C3.3) were analyzed. Fracture steps involving the antero-latero-central (ALC) segment were insufficiently reduced after fluoroscopy using both approaches (AL 2.2 ± 1.2 mm vs PL 2.2 ± 1.0 mm, p 0.95). Additional NS and ECO achieved optimized fracture reduction in the ALC segment (NS AL 1.6 ± 1.3 mm vs PL 0.8 ± 0.9 mm, p 0.32). NS provided visualization of the entire lateral plateau (PL 102.9% ± 7.4, AL 108.8 ± 19.2%), while fracturoscopy only allowed visualization of the ALL segment and partially of PLL and ALC segments (PL 22.0 ± 23.4%, AL 29.7 ± 18.3%).

Conclusion

Optimized reduction of tibial head fractures with involvement of latero-central segments requires additional video-assisted reduction or extended approaches. Nanoscopy helps visualizing of the entire lateral plateau, when compared to fracturoscopy and may become a valuable reduction aid.

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Title: Nanoscopy and an extended lateral approach can improve the management of latero-central segments in tibial plateau fractures: a cadaveric study
Authors: Peter Behrendt
M. T. Berninger
G. Thürig
J. Dehoust
J. Christensen
K.-H. Frosch
M. Krause
M. J. Hartel
Publication date: 09-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Pityriasis Lichenoides Chronica
Tibial Plateau Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02188-3

At a glance: The STEP trials

Springer Medicine

Nanoscopy and an extended lateral approach can improve the management of latero-central segments in tibial plateau fractures: a cadaveric study

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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