[Minimally invasive treatment of monocondylar tibial plateau fractures. Percutaneous reduction and small fragment osteosynthesis].
BACKGROUND
Treatment of displaced tibial plateau fractures is often complicated by high-energy trauma and soft tissue damage. Therefore, numerous techniques such as indirect or arthroscopically controlled reduction and percutaneous osteosynthesis have been described to reduce the additional surgical trauma.


METHODS
Twenty-three fractures (AO type 41-B2/3, Schatzker type II-IV) were treated with percutaneous, fluoroscopically guided reduction combined with small fragment osteosynthesis using a radius T-plate. In none of the patient was cancellous bone graft performed. Only in one case was arthrotomy necessary because of uncertain image intensification findings in an obese patient. One revision was done for a 4-mm step caused by an over reduced rim fragment. Fracture healing and full weight bearing were achieved after 8-12 weeks. Neither secondary displacement nor implant loosening was seen under primary functional treatment without immobilization.


RESULTS
Functional recovery showed a mean ROM of 114 degrees after 6 weeks and 121 degrees after 3 months. The radius T-plate offers enough stability to allow primary functional treatment due to early recovery of joint motion. Percutaneous reduction and small fragment osteosynthesis is a less invasive approach in the treatment of displaced monocondylar tibial plateau fractures.
Walz
M
M
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum Uelzen. walzmed@web.de
Auerbach
F
F
Kolbow
B
B
Junker
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D036542:Tomography, Spiral Computed