Arthroscopic-assisted inflatable bone tamp reduction for treatment of posterolateral tibial plateau fractures

Injury. 2018 Nov;49(11):2061-2067. doi: 10.1016/j.injury.2018.09.015. Epub 2018 Sep 8.

Abstract

Aim: Our study aimed to assess the safety and efficacy of an innovative arthroscopic-assisted inflatable tamp reduction technique for the treatment of posterolateral tibial plateau fractures.

Patients and methods: Twenty-six patients with posterolateral tibial plateau fractures were treated with arthroscopy through inflation reduction technique were enrolled. Arthroscopy was used to observe the reduction of articular surface to avoid over-reduction or de-reduction. An arthroscopic assessment of anatomic joint reduction completed the procedure. Inflatable bone tamp was used to reduce the fractures and calcium phosphate cement was used as bone substitute to augment the repairs.

Results: Under arthroscopy, the reduction was observed to be excellent without any residual deformity in all the cases. Cement overflow into the soft tissues or the knee joint was not observed. During the follow-up period, no obvious articular surface subsidence (>5 mm) was observed and no evidence of posttraumatic osteoarthritis could be detected. Radiographs under full weight bearing revealed neither loss of reduction nor any valgus deviation. Three months after surgery, the graft was almost completely replaced by new bone. The functional evaluation following the Rasmussen score yielded excellent results.

Conclusions: This study provided a novel technique for the reduction of depressed and split-depressed pasterolateral tibial plateau fractures. Arthroscopic-assisted inflatable bone tamp reduction is an effective method for the treatment of posterolateral tibial plateau fractures.

Keywords: Arthroscopic-assisted; Calcium sulfate; Inflatable bone tamp; Posterolateral tibial plateau fracture.

MeSH terms

  • Adult
  • Arthroscopy / methods*
  • Bone Cements / therapeutic use
  • Bone Transplantation / methods*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal*
  • Fracture Healing / physiology*
  • Humans
  • Intra-Articular Fractures / diagnostic imaging
  • Intra-Articular Fractures / physiopathology
  • Intra-Articular Fractures / surgery*
  • Male
  • Middle Aged
  • Radiography
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / physiopathology
  • Tibial Fractures / surgery*
  • Treatment Outcome

Substances

  • Bone Cements