The concept of direct approach to lateral tibial plateau fractures and stepwise extension as needed.
Malreduction after tibial plateau fractures mainly occurs due to insufficient visualization of the articular surface. In 85% of all C-type fractures an involvement of the posterolateral-central segment is observed, which is the main region of malreduction. The choice of the approach is determined (1...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 46; no. 6; pp. 1211 - 1220 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images pictorial review tables/charts Journal Article |
| Publicado: |
Springer Nature
2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=147225379&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 147225379 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: 2020 vid: 46 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 147225379 144444453 147225379 147225379 10.1007/s00068-020-01422-0 147225379 ppf: 1211 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The concept of direct approach to lateral tibial plateau fractures and stepwise extension as needed. aug: au: Frosch, Karl-Heinz Korthaus, Alexander Thiesen, Darius Frings, Jannik Krause, Matthias affil: Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany sug: subj: Tibial Plateau Fracture Surgery Fracture Fixation Methods Orthopedic Fixation Devices Orthopedic Surgery Osteotomy Subluxation ab: Malreduction after tibial plateau fractures mainly occurs due to insufficient visualization of the articular surface. In 85% of all C-type fractures an involvement of the posterolateral-central segment is observed, which is the main region of malreduction. The choice of the approach is determined (1) by the articular area which needs to be visualized and (2) the positioning of the fixation material. For simple lateral plateau fractures without involvement of the posterolateral-central segment an anterolateral standard approach in supine position with a lateral plating is the treatment of choice in most cases. For complex fractures the surgeon has to consider, that the articular surface of the lateral plateau only can be completely visualized by extended approaches in supine, lateral and prone position. Anterolateral and lateral plating can also be performed in supine, lateral and prone position. A direct fixation of the posterolateral-central segment by a plate or a screw from posterior can be only achieved in prone or lateral position, not supine. The posterolateral approach includes the use of two windows for direct visualization of the fracture. If visualization is insufficient the approach can be extended by lateral epicondylar osteotomy which allows exposure of at least 83% of the lateral articular surface. Additional central subluxation of the lateral meniscus allows to expose almost 100% of the articular surface. The concept of stepwise extension of the approach is helpful and should be individually performed as needed to achieve anatomic reduction and stable fixation of tibial plateau fractures. pubtype: Academic Journal doctype: diagnostic images pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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