Combined arthroscopic treatment of tibial plateau and intercondylar eminence avulsion fractures
| Autor: | Roberto Buda, Alberto Ferruzzi, Antonio Timoncini, Riccardo Ghermandi, Sandro Giannini, Francesco Di Caprio, Alessandro Parma |
|---|---|
| Přispěvatelé: | Di Caprio F., Buda R., Ghermandi R., Ferruzzi A., Timoncini A., Parma A., Giannini S. |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Knee arthritis
Adult Male musculoskeletal diseases medicine.medical_specialty Knee Joint medicine.medical_treatment Avulsion Arthroscopy medicine Tibial plateau fracture Internal fixation Humans Orthopedics and Sports Medicine medicine.diagnostic_test business.industry Avulsion fracture General Medicine medicine.disease musculoskeletal system Surgery Tibial Fractures Knee pain Treatment Outcome avulsion fracture Orthopedic surgery fracture fixation Female medicine.symptom business |
| Popis: | Fractures of the tibial plateau represent 1% of all fractures and 8% of fractures in the elderly population1. These fractures represent a surgical challenge because of the variety of fracture patterns and the associated soft-tissue injuries. If not adequately treated, these fractures often cause persistent knee pain, arthritis, and angular deformity. In one study, posttraumatic knee arthritis following a tibial plateau fracture was reported, after a seven-year follow-up, in 74% of patients with an associated meniscal tear and in 34% of patients with intact menisci2. Intercondylar eminence avulsion fractures are relatively uncommon. First described by Poncet in 1875, this injury usually has been considered to be the childhood equivalent of anterior cruciate ligament rupture in adults3. As an isolated injury, these fractures are most frequent in pediatric patients between the ages of eight and fourteen years4-9. These lesions also can occur in adults in association with another periarticular injury or a tibial plateau fracture3,5. In our experience, 19.4% of tibial plateau fractures have been associated with an intercondylar eminence fracture whereas 84.3% of tibial spine fractures in adults have been associated with a tibial plateau fracture (unpublished data). Associated tibial plateau and intercondylar eminence avulsion fractures are complex articular lesions that vary widely from one patient to another, and therefore treatment requires personalized solutions. When determining the best treatment, anatomic joint reconstruction with minimally invasive techniques should be considered. Arthroscopic reduction and internal fixation have demonstrated various advantages over open reduction and internal fixation in terms of surgical morbidity, time of hospital stay, recovery, and complications such as infection and loss of knee motion10-12. The high prevalence of associated intra-articular lesions justifies the use of arthroscopy to evaluate and treat all of … |
| Databáze: | OpenAIRE |
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