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Percutaneous cement augmentation for the treatment of depression fractures of the tibial plateau

Evangelopoulos, D. ; Heitkemper, S. ; Eggli, S. ; Haupt, U. ; Exadaktylos, A. ; Benneker, L.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2010, vol. 18, no. 7, p. 911-915

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    Titel
    • Percutaneous cement augmentation for the treatment of depression fractures of the tibial plateau
    Autor
    • Evangelopoulos, D.. Department of Orthopedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Heitkemper, S.. Department of Orthopedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Eggli, S.. Department of Orthopedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Haupt, U.. Department of Orthopedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland
    • Exadaktylos, A.. Department of Emergency Medicine, Inselspital, University of Bern, Bern, Switzerland
    • Benneker, L.. Department of Orthopedic Surgery, Inselspital, University of Bern, 3010, Bern, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Knee Surgery, Sports Traumatology, Arthroscopy, 2010, vol. 18, no. 7, p. 911-915. Springer-Verlag
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:318537
    Summary
    The management of insufficiency fractures of the tibial plateau in osteoporotic patients can be very challenging, since it is difficult to achieve a stable fixation, an essential condition for the patients' early mobilization. We present a minimally invasive technique for the treatment of proximal tibial plateau fractures, "tibiaplasty”, using percutaneous polymethylmethacrylate augmentation. Five osteoporotic patients (7 fractures) with a non-traumatic insufficiency tibial plateau fracture were treated with this technique at the authors' institution from 2006 to 2008. The patients' median age was 79 (range 62-88) years. The intervention was performed percutaneously under general or spinal anesthesia; after the intervention, immediate full weight bearing was allowed. The technique was feasible in all patients and no complications related to the intervention were observed. All patients reported a relevant reduction in pain, were able to mobilize with full weight bearing and would undergo the operation again. No secondary loss of reduction or progression of arthrosis was observed in radiological controls; no revision surgery was required. Our initial results indicate that tibiaplasty is a good treatment option for the management of insufficiency in tibial plateau fractures in osteoporotic patients. The technique is minimally invasive, safe and allows immediate mobilization without restrictions. In our group of patients, we found excellent early to mid-term results