Percutaneous surgery with balloon for tibial plateau fractures, results with a minimum of 5 years of follow-up. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Vendeuvre, Tanguy; Ferrière, Victor; Bouget, Pierre; Billot, Maxime; Germaneau, Arnaud; Severyns, Mathieu; Roulaud, Manuel; Rigoard, Philippe; Pries, Pierre
• Is Part Of: Injury. Volume 53:Issue 7(2022)
• Page Start: 2650
• Page End: 2656
• Publication Date: 2022-07
• Subjects: Tuberoplasty -- Tibial plateau fracture -- Tibial plateau depression -- Schatzker -- Arthroscopy; 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.2022.05.033
• Languages: English
• ISSNs: 0020-1383

Abstract

Highlights: Tuberoplasty allows percutaneous reduction of tibial plateau depressions. Filling with PMMA with osteosynthesis allows early rehabilitation and weight-bearing recovery. Arthroscopy allows control of the reduction and treatment of associated lesions. Abstract: Tibial plateau fracture is a frequent entity for which surgical management is difficult both surgically and postoperatively, with multiple complications and often delayed recovery. The challenge lies in the anatomical reduction of the joint, the limitation of complications and the rapid functional recovery. Tuberoplasty appears to be an innovative technique that meets current expectations. The objective is to evaluate the reliability of tuberoplasty in reducing surgical risks and improving postoperative clinical results. This single-centre retrospective study included 30 patients with depressed tibial plateau fractures who underwent tuberoplasty from September 2011 to March 2014. Reduction analysis was performed by comparing pre-operative and post-operative depression from computed tomography (CT) data. Clinical outcomes were assessed by measuring flexion joint ranges, time to weight-bearing, KOOS questionnaire and a pangonogram. The mean depression was 7.4mm pre-operatively and 2.6mm [0;9] post-operatively, with 47% (14/30) having a residual depression of 2mm or less. Mean flexion at 6 weeks was 103° [30; 130]. Partial and total weight-bearing were allowed on day 47 [3; 150] and day 58 [20; 150], respectively. The mean KOOS score was 25.43 [1.15; 62.30] at a minimum of 5 years after surgery and the mean axis was 176.54° [172; 180]. There was one case of thrombophlebitis and one sensory-motor deficit in the common fibular nerve territory. The reduction of the tibial plateau observed in our study from tuberoplasty is in line with the literature results obtained from a conventional approach. Our results indicate that tuberoplasty is stable in the long term, has good functional results and early recovery with few complications. This preliminary study presents results that need to be investigated in a prospective randomised double-blind study.