"Out-in" position in the surgical treatment of three-column tibial plateau fractures: A technical note. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Zheng, Yang; Zhang, Jiu-Dan; Shen, Jian-Jian; Huang, Jie-Feng
• Is Part Of: Injury. Volume 52:Issue 4(2021)
• Page Start: 1074
• Page End: 1078
• Publication Date: 2021-04
• Subjects: Tibial plateau fracture -- Three-column classification -- "Out-in" position -- Combined approach; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2020.10.096
• Languages: English
• ISSNs: 0020-1383

Abstract

Abstract: Three-column classification of tibial plateau fractures is based on computerized tomography (CT) images, and the patients with three-column fractures can be treated with posteromedial combined with anterolateral approach in the floating position. However, there are certain disadvantages to operating in a "floating position". Therefore, we proposed an "out-in" position for those fractures. The patient is placed in supine position on the operating table, and the healthy hip is elevated. For the posteromedial approach, the affected limb should be placed on a rectangular fluoroscopy table and kept in abduction and external rotation (out); for the anterolateral approach, the affected limb is retracted into the operating bed and kept in neutral position (in).This position has been shown to be highly effective for easy operation as well as intraoperative image monitoring. Furthermore, it highlights the advantage of anterior-posterior joint fracture reduction.