Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,

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Presentation transcript:

Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein, and Michael D. McKee J Bone Joint Surg Am Volume 91(Supplement 2 Part 1):74-88 March 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

A preoperative computed tomography scan clarifies the main fracture lines. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Patient positioning. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Traction can be applied with use of either manual means, a femoral distractor, or, rarely, a fracture table. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Following reduction of the articular surface, a fracture clamp is applied percutaneously. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Initial application of the frame. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Wire insertion. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Fixation of the wires to the frame. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Distal fixation of the fixator. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Preoperative radiograph of a displaced bicondylar tibial plateau fracture in a thirty-two-year-old man. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Two operative approaches can be used: (1) a single anterior incision (left), which usually involves substantial soft-tissue stripping, or (2) the preferred two-incision approach (right). Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.