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DOI: 10.1055/s-0039-1697607
Arthroscopic-Guided Balloon Tibioplasty in Schatzker III Tibial Plateau Fracture
Publication History
19 January 2018
06 August 2019
Publication Date:
11 October 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00033766/201804/lookinside/thumbnails/10-1055-s-0039-1697607_1800007-1.jpg)
Abstract
Purpose The study aims to present the results at a mean 28-months follow-up of arthroscopic-guided balloon tibioplasty and to spot some technical tricks and some practice using tools and materials.
Methods The study relates to six patients with tibial plateau fractures type Schatzker III with tibial plateau depression more than 4 mm at preoperative computed tomography scan (CT-scan). The follow-up period ranged from 22 to 33 months, with a mean of 28 months. No patients were lost to follow-up. The patients were evaluated clinically using the Rasmussen score system and Lysholm score systems at 6 to 12 and 24 months, postoperatively. Radiographic evaluations (standard X-rays) were done preoperatively at 1, 3, and 12 months postoperatively while a CT-scan with 3D reconstruction was performed preoperatively, at the first day and 6 months, postoperatively.
Results The mean Rasmussen clinical score at 6 months postoperatively was 26.3 while at 1-year postoperatively the mean Rasmussen clinical score was 28.33. At 2-year postoperatively the mean Rasmussen clinical score was 28.83. Statistically significant difference was found in 6-months and 2-years results (p < 0.05). CT-scan achieved the first postoperative day showed the recovery of approximately 70% of the area of the interested tibial plateau, restoring of the joint surface without articular bone free fragments.
Conclusion The described surgical procedure, if correctly performed with proper indications (Schatzker III), respect the principles mentioned above and the clinical and radiological results confirm our purpose.
Level of Evidence This is a therapeutic case series, level IV study.
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References
- 1 Petersen W, Zantop T, Raschke M. Tibiakopffraktur. Unfallchirurg 2006; 109 (03) 219-232
- 2 Marsh JL, Slongo TF, Agel J. , et al. Fracture and dislocation classification compendium-2007: Orthopaedic Trauma Association classification, database, and outcomes committee. J Orthop Trauma 2007; 21 (10, Suppl): S1-S133
- 3 Watson JT, Schatzker J. Tibial plateau fractures. In: Browner BD. , ed. Skeletal Trauma: Basic Science, Management, and Reconstruction. 3rd ed. Philadelphia, PA: Saunders; 2003: 2047-2130
- 4 Caspari RB, Hutton PM, Whipple TL, Meyers JF. The role of arthroscopy in the management of tibial plateau fractures. Arthroscopy 1985; 1 (02) 76-82
- 5 Jennings JE. Arthroscopic management of tibial plateau fractures. Arthroscopy 1985; 1 (03) 160-168
- 6 Broome B, Mauffrey C, Statton J, Voor M, Seligson D. Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius. J Orthop Traumatol 2012; 13 (02) 89-95
- 7 Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am 1973; 55 (07) 1331-1350
- 8 Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 1985; (198) 43-49
- 9 Doria C, Balsano M, Spiga M, Mosele GR, Puddu L, Caggiari G. Tibioplasty, a new technique in the management of tibial plateau fracture: a multicentric experience review. J Orthop 2017; 14 (01) 176-181
- 10 Bano A, Pasku D, Karantanas A, Alpantaki K, Souvatzis X, Katonis P. Intra-articular calcaneal fracture: closed reduction and balloon-assisted augmentation with calcium phosphate cement: a case report. Cases J 2009; 2: 9290
- 11 Heim KA, Sullivan C, Parekh SG. Cuboid reduction and fixation using a kyphoplasty balloon: a case report. Foot Ankle Int 2008; 29 (11) 1154-1157
- 12 Iida K, Sudo A, Ishiguro S. Clinical and radiological results of calcium phosphate cement-assisted balloon osteoplasty for Colles' fractures in osteoporotic senile female patients. J Orthop Sci 2010; 15 (02) 204-209
- 13 König B, Khodadadyan C, Schäffler A, Pflugmacher R, Stöckle U. [Percutaneously navigated balloon fracture reduction in a displaced acetabular fracture]. Unfallchirurg 2007; 110 (12) 1072-1075
- 14 Reiley MA. Abstracts from the 8th annual meeting of the international society for fracture repair. Number 800 Percutaneous balloon-plasty technique. J Orthop Trauma 2003; 17: 141-163
- 15 Pizanis A, Garcia P, Pohlemann T, Burkhardt M. Balloon tibioplasty: a useful tool for reduction of tibial plateau depression fractures. J Orthop Trauma 2012; 26 (07) e88-e93
- 16 Hahnhaussen J, Hak DJ, Weckbach S, Heiney JP, Stahel PF. Percutaneous inflation osteoplasty for indirect reduction of depressed tibial plateau fractures. Orthopedics 2012; 35 (09) 768-772
- 17 Ollivier M, Turati M, Munier M, Lunebourg A, Argenson JN, Parratte S. Balloon tibioplasty for reduction of depressed tibial plateau fractures: preliminary radiographic and clinical results. Int Orthop 2016; 40 (09) 1961-1966
- 18 Mauffrey C, Fader R, Hammerberg EM, Hak DJ, Stahel PF. Incidence and pattern of technical complications in balloon-guided osteoplasty for depressed tibial plateau fractures: a pilot study in 20 consecutive patients. Patient Saf Surg 2013; 7 (01) 8
- 19 Mauffrey C, Roberts G, Cuellar DO, Herbert B, Hak D. Balloon tibioplasty: pearls and pitfalls. J Knee Surg 2014; 27 (01) 31-37
- 20 Belaid D, Vendeuvre T, Bouchoucha A. , et al. Utility of cement injection to stabilize split-depression tibial plateau fracture by minimally invasive methods: a finite element analysis. Clin Biomech (Bristol, Avon) 2018; 56: 27-35
- 21 Simpson D, Keating JF. Outcome of tibial plateau fractures managed with calcium phosphate cement. Injury 2004; 35 (09) 913-918
- 22 Dall'oca C, Maluta T, Lavini F, Bondi M, Micheloni GM, Bartolozzi P. Tibial plateau fractures: compared outcomes between ARIF and ORIF. Strateg Trauma Limb Reconstr 2012; 7 (03) 163-175
- 23 Wang JQ, Jiang BJ, Guo WJ, Zhang WJ, Li AB, Zhao YM. Arthroscopic-assisted balloon tibioplasty versus open reduction internal fixation (ORIF) for treatment of Schatzker II-IV tibial plateau fractures: study protocol of a randomised controlled trial. BMJ Open 2018; 8 (08) e021667