Abstract：
BACKGROUND:The standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band (IT) and anterior tibialis origin in continuity from Gerdy's tubercle and metaphyseal flare. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertion to Gerdy's tubercle. DESCRIPTION OF TECHNIQUE:The approach entails a partial tenotomy of the anterior half of the IT band leaving the posterior IT band insertion attached to Gerdy's tubercle. Fracture lines around Gerdy's tubercle are completed or the tubercle was osteotomized and externally rotated and the joint overdistracted, allowing direct visualization of the joint depression. Joint elevation, grafting, and internal fixation are performed through this window. METHODS:We retrospectively reviewed 76 patients (two groups), Schatzker Types I to II and IV to VI fractures (66 patients), between 1989 and 2005, and 10 patients, with 10 bicondylar posterior plateau fractures, from 2002 to 2010. All patients were followed a minimum of 12 months (average, 3.9 years; range, 12 months to 10 years). Ten patients, with posterior plateau fractures, received anterolateral plateau intraarticular osteotomy for exposure of centroposterior and posterolateral articular depression. RESULTS:Average knee ROM was 2° of flexion (range, -3° to 5°) to greater than 120° of flexion (range, 100°-145°). In 66 patients, average articular depression improved from 7.4 mm to 1 mm (range, 0-5 mm) and, in 10 posterior fractures, from 18 mm to 1 mm (range, 0-4.5 mm). Infection occurred in one of the 76 patients; acute débridement and intravenous antibiotics resulted in control of the infection. CONCLUSIONS:This approach reliably increases direct visualization of the lateral plateau articular fractures and maintains IT band insertion. Articular osteotomy of the anterolateral plateau provides access to extensive posterior plateau fractures.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Johnson EE,Timon S,Osuji Cdoi
10.1007/s11999-013-2962-2subject
Has Abstractpub_date
2013-09-01 00:00:00pages
2760-7issue
9eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:Forty-nine children with diaphyseal both-bone forearm fractures were treated with either both-bone intramedullary wire fixation (24), single ulnar intramedullary wire fixation (22), or single radial intramedullary wire fixation (3). Six fractures were open and 43 were closed. A limited open approach to one or both bon...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200209000-00024
更新日期：2002-09-01 00:00:00
abstract：:Between 1974 and 1989, 315 primary total hip replacements (274 patients) were done using the cemented Weber Rotation prosthesis and standardized operative technique, which was modified for the stem in 1978. After the first postoperative year, all patients had routine clinical and radiologic examinations at 2-year inte...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2004-02-01 00:00:00
abstract：:The alkaline phosphatase in leukocytes (LAP) was measured in patients who had undergone various types of total arthroplasty of the hip, in patients who had undergone synovectomy and in whom tibial fractures had been treated conservatively. The LAP-Score increased rapidly and reached a maximum within a few days and ret...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-01-01 00:00:00
abstract：:To analyze the influence of varying viscosity and mixing temperature (22 degrees C and 6 degrees C) on macro- and microporosity, density, and compressive strength in vacuum mixed bone cement, high, medium, and low viscosity cement were mixed in 2 vacuum mixing systems and compared with bowl mixing at atmospheric press...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND:The skeleton plays a critical structural role in bearing functional loads, and failure to do so results in fracture. As we evaluate new therapeutics and consider treatments to prevent skeletal fractures, understanding the basic mechanics underlying whole bone testing and the key principles and characteristic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-011-1784-3
更新日期：2011-08-01 00:00:00
abstract：:One hundred eighty-three total hip arthroplasties were revised for deep infection in a 1-stage procedure using antibiotic containing acrylic cement and systemic perioperative antibiotics. At an average followup of 7 years 9 months, 154 (84.2%) patients were free of infection. The remaining 29 (15.8%) patients had evid...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
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更新日期：1995-12-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3565-2
更新日期：2014-06-01 00:00:00
abstract：:Twenty-nine patients with 30 intraarticular proximal tibial fractures were treated with early application of a cast brace. All fractures united, knee motion was excellent or good in all but one patient. The fracture fragments did not lose position after cast brace application. Varus or valgus deformities could be corr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000053
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3111-7
更新日期：2014-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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doi：10.1007/s11999-008-0479-x
更新日期：2009-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：:Failed surgery at the hallux metatarsophalangeal joint may present substantial difficulties in treatment, especially when complicated by infection. This retrospective study reviews the staged treatment of 5 patients with complications of hallux valgus surgery associated with sepsis of the metatarsophalangeal joint. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2214-2
更新日期：2012-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-02-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0251-2
更新日期：2008-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
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更新日期：2004-07-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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doi：10.1007/s11999-013-3046-z
更新日期：2013-08-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章
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更新日期：1997-04-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1987-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200105000-00021
更新日期：2001-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-06-01 00:00:00
