Posterior Circumferential Support in Tibial Plateau Fractures
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Published:
Apr 14, 2021
Keywords:
Tibial fractures, tibial plateau, internal fixation, posteromedial approach
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Abstract
Surgical techniques commonly used today for tibial plateau fractures do not properly contemplate multiplanar bone comminution nor the presence of posterior bone fragments. We have faced this problem when treating a patient with a Schatzker VI type fracture, in which the commonly used osteosynthesis was supplemented with a posterior horizontal circumferential plate. Bone consolidation and good results were achieved in the short term in the case we present. From the analysis of the cited literature, we concluded that several techniques for containing posterior tibial plateau bone comminution have been developed. Among them, circumferential osteosynthesis is a technique to take into account.
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How to Cite
De Cicco, F. L., Verbner, J. M., Abrego, M. O., Taype, D. R., Carabelli, G. S., Barla, J. D., & Sancineto, C. F. (2021). Posterior Circumferential Support in Tibial Plateau Fractures. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(2), 219-227. https://doi.org/10.15417/issn.1852-7434.2021.86.2.1018
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References
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10. Chang S-M, Wang X, Zhou J-Q, Huang Y-G, Zhu X-Z. Posterior coronal plating of bicondylar tibial plateau fractures through posteromedial and anterolateral approaches in a healthy floating supine position. Orthopedics. 2012;35(7):583–8. https://doi.org/10.3928/01477447-20120621-03
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13. Chang S-M, Hu S-J, Zhang Y-Q, Yao M-W, Ma Z, Wang X, et al. A surgical protocol for bicondylar four-quadrant tibial plateau fractures. Int Orthop. 2014;38(12):2559–64. https://doi.org/10.1007/s00264-014-2487-7
14. Krieg JC. Proximal tibial fractures: current treatment, results, and problems. Injury. 2003;34 (Suppl 1):A2-10. https://doi.org/10.1016/s0020-1383(03)00252-3.
15. Ricci WM, Rudzki JR, Borrelli J. Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trauma. 2004;18(8):521–7. https://doi.org/10.1097/00005131-200409000-00007.
16. Bhattacharyya T, McCarty LP, Harris MB, Morrison SM, Wixted JJ, Vrahas MS, et al. The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. J Orthop Trauma. 2005;19(5):305–10. PMID: 15891538
17. Bermúdez CA, Ziran BH, Barrette-Grischow M-K. Use of horizontal rafting plates for posterior elements of complex tibial plateau fractures: description and case reports. J Trauma. 2008;65(5):1162–7. https://doi.org/10.1097/01.ta.0000222943.45563.b5.
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19. Zeng Z-M, Luo C-F, Putnis S, Zeng B-F. Biomechanical analysis of posteromedial tibial plateau split fracture fixation. Knee. 2011;18(1):51–4. https://doi.org/10.1016/j.knee.2010.01.006.
20. Aly T, Hafez K, Amin O. Treatment of tibial plateau fractures using cerclage-wiring with surface flat plating technique: short term results. Research. 2014;1:725. https://doi.org/10.13070/rs.en.1.725
21. Lobenhoffer P, Gerich T, Bertram T, Lattermann C, Pohlemann T, Tscheme H. [Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures]. Unfallchirurg. 1997;100(12):957–67. https://doi.org/10.1007/s001130050218.
22. Brunner A, Honigmann P, Horisberger M, Babst R. Open reduction and fixation of medial Moore type II fractures of the tibial plateau by a direct dorsal approach. Arch Orthop Trauma Surg. 2009;129(9):1233–8. https://doi.org/10.1007/s00402-009-0841-9.
23. Yu B, Han K, Zhan C, Zhang C, Ma H, Su J. Fibular head osteotomy: a new approach for the treatment of lateral or posterolateral tibial plateau fractures. Knee. 2010;17(5):313–8. https://doi.org/10.1016/j.knee.2010.01.002.
24. Frosch K-H, Balcarek P, Walde T, Stürmer KM. [A modified posterolateral approach for the treatment of tibial plateau fractures]. Oper Orthop Traumatol. 2010;22(1):107–19. https://doi.org/10.1007/s00064-010-3008-0.
25. Lugones A. Abordaje posteromedial para la reducción y estabilización del componente posteromedial en fracturas del platillo tibial. Rev Asoc Argent Ortop Traumatol. 2010;75 (2):144–50. Disponible en: http://www.aaot.org.ar/revista/2010/n2/Rev_AsocArgentOrtopTraumatol_2010_75_144-150_Lugones.pdf
26. Garner MR, Warner SJ, Lorich DG. Surgical approaches to posterolateral tibial plateau fractures. J Knee Surg. 2016 ;29(1):12–20. https://doi.org/10.1055/s-0035-1564731
27. Hake ME, Goulet JA. Open reduction and internal fixation of the posteromedial tibial plateau via the Lobenhoffer approach. J Orthop Trauma. 2016;30(Suppl 2):S35-6. https://doi.org/10.1097/BOT.0000000000000582.
2. Robledo-Herrera O, Diego-Ball D, Oliva-Ramirez S. [Posteromedial approach and plating for a tibial plateau fracture with a posterior fragment]. Acta Ortop Mex. 2015; 29(2):69–76. Disponible en: https://www.medigraphic.com/pdfs/ortope/or-2015/or152b.pdf.
3. Weil YA, Gardner MJ, Boraiah S, Helfet DL, Lorich DG. Posteromedial supine approach for reduction and fixation of medial and bicondylar tibial plateau fractures. J Orthop Trauma. 2008;22(5):357–62. https://doi.org/10.1097/BOT.0b013e318168c72e.
4. He X, Ye P, Hu Y, Huang L, Zhang F, Liu G, et al. A posterior inverted L-shaped approach for the treatment of posterior bicondylar tibial plateau fractures. Arch Orthop Trauma Surg. 2013;133(1):23–8. https://doi.org/10.1007/s00402-012-1632-2.
5. Chen H-W, Chen C-Q, Yi X-H. Posterior tibial plateau fracture: a new treatment-oriented classification and surgical management. Int J Clin Exp Med. 2015; 15;8(1):472–9. PMID: 25785019
6. Luo C-F, Sun H, Zhang B, Zeng B-F. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma. 2010;24(11):683-92. https://doi.org/10.1097/BOT.0b013e3181d436f3.
7. Wicky S, Blaser PF, Blanc CH, Leyvraz PF, Schnyder P, Meuli RA. Comparison between standard radiography and spiral CT with 3D reconstruction in the evaluation, classification and management of tibial plateau fractures. Eur Radiol. 2000;10(8):1227–32. https://doi.org/10.1007/s003300000326.
8. Barei DP, O’Mara TJ, Taitsman LA, Dunbar RP, Nork SE. Frequency and fracture morphology of the posteromedial fragment in bicondylar tibial plateau fracture patterns. J Orthop Trauma. 2008;22(3):176–82. https://doi.org/10.1097/BOT.0b013e318169ef08.
9. Khan RM, Khan SH, Ahmad AJ, Umar M. Tibial plateau fractures. A new lassification scheme. Clin Orthop Relat Res. 2000; (375):231–42. PMID: 10853174
10. Chang S-M, Wang X, Zhou J-Q, Huang Y-G, Zhu X-Z. Posterior coronal plating of bicondylar tibial plateau fractures through posteromedial and anterolateral approaches in a healthy floating supine position. Orthopedics. 2012;35(7):583–8. https://doi.org/10.3928/01477447-20120621-03
11. De Boeck H, Opdecam P. Posteromedial tibial plateau fractures. Operative treatment by posterior approach. Clin Orthop Relat Res. 1995;(320):125–8. PMID: 7586815.
12. Carlson DA. Posterior bicondylar tibial plateau fractures. J Orthop Trauma. 2005; 19(2):73–8. https://doi.org/10.1097/00005131-200502000-00001.
13. Chang S-M, Hu S-J, Zhang Y-Q, Yao M-W, Ma Z, Wang X, et al. A surgical protocol for bicondylar four-quadrant tibial plateau fractures. Int Orthop. 2014;38(12):2559–64. https://doi.org/10.1007/s00264-014-2487-7
14. Krieg JC. Proximal tibial fractures: current treatment, results, and problems. Injury. 2003;34 (Suppl 1):A2-10. https://doi.org/10.1016/s0020-1383(03)00252-3.
15. Ricci WM, Rudzki JR, Borrelli J. Treatment of complex proximal tibia fractures with the less invasive skeletal stabilization system. J Orthop Trauma. 2004;18(8):521–7. https://doi.org/10.1097/00005131-200409000-00007.
16. Bhattacharyya T, McCarty LP, Harris MB, Morrison SM, Wixted JJ, Vrahas MS, et al. The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. J Orthop Trauma. 2005;19(5):305–10. PMID: 15891538
17. Bermúdez CA, Ziran BH, Barrette-Grischow M-K. Use of horizontal rafting plates for posterior elements of complex tibial plateau fractures: description and case reports. J Trauma. 2008;65(5):1162–7. https://doi.org/10.1097/01.ta.0000222943.45563.b5.
18. Georgiadis GM. Combined anterior and posterior approaches for complex tibial plateau fractures. J Bone Joint Surg Br. 1994;76(2):285–9. PMID: 8113294
19. Zeng Z-M, Luo C-F, Putnis S, Zeng B-F. Biomechanical analysis of posteromedial tibial plateau split fracture fixation. Knee. 2011;18(1):51–4. https://doi.org/10.1016/j.knee.2010.01.006.
20. Aly T, Hafez K, Amin O. Treatment of tibial plateau fractures using cerclage-wiring with surface flat plating technique: short term results. Research. 2014;1:725. https://doi.org/10.13070/rs.en.1.725
21. Lobenhoffer P, Gerich T, Bertram T, Lattermann C, Pohlemann T, Tscheme H. [Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures]. Unfallchirurg. 1997;100(12):957–67. https://doi.org/10.1007/s001130050218.
22. Brunner A, Honigmann P, Horisberger M, Babst R. Open reduction and fixation of medial Moore type II fractures of the tibial plateau by a direct dorsal approach. Arch Orthop Trauma Surg. 2009;129(9):1233–8. https://doi.org/10.1007/s00402-009-0841-9.
23. Yu B, Han K, Zhan C, Zhang C, Ma H, Su J. Fibular head osteotomy: a new approach for the treatment of lateral or posterolateral tibial plateau fractures. Knee. 2010;17(5):313–8. https://doi.org/10.1016/j.knee.2010.01.002.
24. Frosch K-H, Balcarek P, Walde T, Stürmer KM. [A modified posterolateral approach for the treatment of tibial plateau fractures]. Oper Orthop Traumatol. 2010;22(1):107–19. https://doi.org/10.1007/s00064-010-3008-0.
25. Lugones A. Abordaje posteromedial para la reducción y estabilización del componente posteromedial en fracturas del platillo tibial. Rev Asoc Argent Ortop Traumatol. 2010;75 (2):144–50. Disponible en: http://www.aaot.org.ar/revista/2010/n2/Rev_AsocArgentOrtopTraumatol_2010_75_144-150_Lugones.pdf
26. Garner MR, Warner SJ, Lorich DG. Surgical approaches to posterolateral tibial plateau fractures. J Knee Surg. 2016 ;29(1):12–20. https://doi.org/10.1055/s-0035-1564731
27. Hake ME, Goulet JA. Open reduction and internal fixation of the posteromedial tibial plateau via the Lobenhoffer approach. J Orthop Trauma. 2016;30(Suppl 2):S35-6. https://doi.org/10.1097/BOT.0000000000000582.