Tibial tubercle osteotomy to improve exposure in complex knee fractures: A cadaveric study and case series |
| |
| Affiliation: | 1. Royal Perth Hospital, Western Australia, Australia;2. Department of Orthopaedic Surgery, Kantonsspital St. Gallen, Rorschacher Strasse 95, St. Gallen CH-9007, Switzerland;3. Royal Perth Hospital, Department of Orthopaedics, 197 Wellington St, Subiaco, Western Australia 6008, Australia;4. The University of Western Australia, 35 Stirling Hwy, Crawley Western Australia 6009, Australia;5. Perth Orthopaedics and Sports Medicine Centre, 31 Outram St, West Perth, Western Australia 6005, Australia;1. Department of Orthopaedic Surgery, St. Cloud Orthopedics and St. Cloud Hospital, St. Cloud, MN, United States;2. Scientific Research and Statistics with Stryker, Trauma and Extremities, Kiel, Germany;1. Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, South Korea;2. Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea;1. Department of Orthopaedics, Royal Sussex County Hospital, Eastern Rd, Brighton BN2 5BE, UK;2. Department of Orthopaedics, Worthing hospital, Lyndhurst Rd, Worthing BN11 2DH, UK;3. Department of Orthopaedics, Waikato Hospital, Selwyn Street and Pembroke Street, Hamilton 3204, New Zealand |
| |
| Abstract: | Adequate exposure is fundamental to safely and correctly perform open procedures around the knee. Tibial tubercle osteotomy (TTO) has previously been described as a method to improve exposure, particularly in complex primary elective knee arthroplasty or revision surgery. We describe a tibial tubercle osteotomy technique to improve exposure in complex knee fractures and a cadaveric study and trauma case series.MethodsA cadaveric study using 8 knee specimens was conducted using a lateral subvastus approach to the knee. Standardised pictures were taken of the exposure, the tibial tubercle osteotomy was performed and pictures were taken of the new exposed area. These images were compared using a computer program that calculated the area of exposure before and after tibial tubercle osteotomy and the results analysed. The technique was then used in a case series of 6 different complex knee fractures including three distal femoral, one periprosthetic distal femur and two tibial plateau fractures. The outcomes of these patients were followed clinically and radiologically.ResultsAll specimens in the cadaveric study demonstrated an increase in area of exposure after the TTO with a mean increase of 148%. All tibial tubercle osteotomies performed in the trauma case series were united by 6 months without complication.ConclusionsTibial tubercle osteotomy is a recognised technique for improving exposure to the knee. This has been demonstrated in a cadaveric study and in a case series of six complex fractures around the knee. If performed properly, this technique can be extended to appropriate trauma cases with good results. |
| |
| Keywords: | Knee fracture Intra articular fracture Tibial tubercle osteotomy Lateral subvastus approach |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
