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Open reduction and internal fixation of posterior column tibial plateau fracture with Synthes proximal tibial LISS plate

Overview

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Learn the Open reduction and internal fixation of posterior column tibial plateau fracture with Synthes proximal tibial LISS plate surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Open reduction and internal fixation of posterior column tibial plateau fracture with Synthes proximal tibial LISS plate surgical procedure.

As with much of adult trauma tibial plateau fractures have a bimodal distribution. In younger patients these injuries result from high energy mechanisms such as falls from height or road traffic accidents whereas in the elderly population they more often result from simple falls.

Tibial plateau injuries have been classified by Schatzker, on the basis of plain film radiographs, into 6 types. Types 5 (bicondylar) and type 6 (bicondylar with complete separation of the joint surface from the tibial shaft) represent the higher energy injuries.  A more recent classification by Luo, based on CT scans, divides the tibial plateau into 3 columns, medial, lateral and posterior and helps to guide the surgical approach to the fracture depending on the precise fracture configuration.

The majority of tibial plateau fractures involve the lateral side and can be approached with the standard anterolateral approach with meniscal elevation.  For those fractures with medial or posterior involvement a number of further approaches are possible from direct medial, postero-medial, direct posterior or even poster-lateral.  Fixation of bicondylar tibial plateau fractures via a single anterior mid-line incision is now generally avoided owing to extensive soft tissue dissection required and the consequential wound problems associated with this approach.

Readers will also find of interest Sleeved Total Knee Replacement for Tibial Plateau Fracture (MBT DePuy)

 

Author:Mr Paul Fenton FRCS (Tr & Orth)

Institution: The Queen Elizabeth Hospital, Birmingham, UK.

Surgical Steps

Welcome to the surgical steps quiz.

This tests your ability to recall the correct order in which the key steps of an operation should be performed.

There will be various legitimate variations in this order but the quiz doesn’t reflect this.
Your reference point for the steps quiz is just our operative technique.
It’s one starting point in helping you to learn the technique.

  • You simply “drag & drop” the boxes containing the descriptions of the steps into the order you think fits and submit for marking.
  • If you get it correct first time you will be presented your certificate at the end of the quiz.
  • If you need to do more work on the steps you access your marked version by clicking the“re-sit the quiz” button.
  • This will show the steps you ordered correctly highlighted in green and the incorrect ones in red.
  • The correct green steps are fixed and won’t move.
  • The red steps move differently after your initial attempt and swap locations with the step they are dragged and dropped onto .
  • Finally resubmit the quiz once again.
  • The quiz will let you keep going until you get all the steps in the right order.
  • The correct green steps are fixed and won’t move.
  • The red steps move differently after your initial attempt and swap locations with the step they are dragged and dropped onto .
  • Finally resubmit the quiz once again.
  • The quiz will let you keep going until you get all the steps in the right order.

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