| Autor: |
Júnior MK; Professor, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine, Ribeirão Preto, Universidade de São Paulo., Fogagnolo F; Assistant Physician, Hospital das Clínicas, School of Medicine, Ribeirão Preto, Universidade de São Paulo., Bitar RC; Assistant Physician, Hospital das Clínicas, School of Medicine, Ribeirão Preto, Universidade de São Paulo., Freitas RL; Assistant Physician, Hospital das Clínicas, School of Medicine, Ribeirão Preto, Universidade de São Paulo., Salim R; Assistant Physician, Hospital das Clínicas, School of Medicine, Ribeirão Preto, Universidade de São Paulo., Jansen Paccola CA; Full Professor, Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, School of Medicine, Ribeirão Preto, Universidade de São Paulo. |
| Abstrakt: |
Tibial plateau fractures are joint lesions that require anatomical reduction of joint surface and functional restoration of mechanical axis of a lower limb. Patient profile, soft tissue conditions, presence of associated injuries and the available infrastructure for the treatment all contribute to the decision making about the best treatment for these fractures. High-energy fractures are usually approached in a staged manner respecting the principle of damage control, and are primarily targeted to maintain limb alignment while the resolution unfavorable soft tissue conditions is pending. Low-energy trauma can be managed on a singlestage basis, provided soft tissues are not an adverse factor, with open reduction and internal fixation. Stable fixation and early painless joint movement are related to a better prognosis. New developments as locked plates, bone replacements, intraoperative 3D imaging are promising and will certainly contribute for less invasive procedures and better outcomes. |
