[Intra-articular osteotomy for malunion of the tibial plateau].

[Intra-articular osteotomy for malunion of the tibial plateau].
Oper Orthop Traumatol. 2020 Jul 28;:
Authors: Lobenhoffer P
Abstract
OBJECTIVE: Restoration of anatomy of the joint surface of the tibial plateau in posttraumatic deformity.
INDICATIONS: Malunions of the tibial plateau with significant intra-articular depression and/or steps.
CONTRAINDICATIONS: Local or systemic infection, critical soft tissues in the area of planned incisions; advanced osteoarthritis of the knee; loss of meniscus in the involved compartment; motoric or neurophysiological impairment hindering normal knee function.
SURGICAL TECHNIQUE: Malunion after posteromedial split fracture: posterior approach in prone position, osteotomy of the former fragment following the fracture lines, anatomical reduction of the fragment in extended position of the knee using the implant as reduction tool, fixation by posterior plate. Malunion after lateral and posterolateral split/depression fracture: Lateral approach with fibula head osteotomy in lateral decubitus position, intra-articular osteotomy of depressed fragments, autologous bone graft, lateral or posterolateral plate osteosynthesis. Osteosynthesis of fibula head with small fragment lag screw or tension-band.
POSTOPERATIVE MANAGEMENT: Walking with crutches starting from day 1 after surgery. Partial weight-bearing until radiographic healing of the osteotomies, usually 4-6 weeks. No lim...

Source: Operative Orthopadie und Traumatologie - July 27, 2020 Category: Orthopaedics Authors: Lobenhoffer P Tags: Oper Orthop Traumatol Source Type: research