title: Navigated reconstruction of tibial head depression fractures by inflation osteoplasty.
abstract: BACKGROUND
  Articular fracture reduction control remains a challenge even with the development of computer-assisted surgery. The Kyphoplasty procedure has shown advantages in treating vertebral fractures. One case report showed successful reduction of acetabular fractures using Kyphoplasty.
  
  
  OBJECTIVE
  This study examines the efficacy of this method in reducing depressed tibial plateau fractures.
  
  
  METHODS
  An insertion sleeve for the Kyphon balloon that could be calibrated by the navigation system was designed. A total of 30 test series in synthetic bone cubes were performed using fracture instruments of 2.5 mm, 5 mm and 15 mm diameter, respectively, creating three different depression fracture depths (mean 1.87 mm, 4.2 mm and 1.72 mm, respectively). The Kyphon balloon was used to attempt reduction of each fracture. The same setup was used for testing in five cadaveric tibia specimens.
  
  
  RESULTS
  After reduction, there was a remaining depression depth mean in the synthetic bone of 0.27 mm for the 2.5 mm instrument; 2.1 mm for the 5 mm instrument; and 1.72 mm for the 15 mm instrument. We could not adequately reduce depression fractures in cadaveric testing.
  
  
  CONCLUSIONS
  The Kyphon balloon was accurately placed with the aid of navigation. The depth was the decisive factor in the reduction of the fracture and not the diameter. In cadavers, depression fractures greater than 5~mm depth could not be reduced with our setup.
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Panzica
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Suero
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Omar
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Bretin
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany.
authors.forename: Musa
authors.initials: M
authors.lastname: Citak
mesh_terms: D006801:Humans; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D013977:Tibia / Q000601:surgery*; D013978:Tibial Fractures / Q000601:surgery*
keywords: CAS; ISO C-3D; Navigation; kyphon; tibial plateau fracture