Balloon Osteoplasty for Depressed Fractures of the Tibial Plateau

Abstract

Tibial plateau fractures represent a wide range of complex injuries that require technical skills for adequate reduction of the articular surface. Anatomic restoration of the joint line and mechanical alignment of the limb are always highly sought after goals, although the exact amount of acceptable step-off is still debated. Traditional surgical methods of reduction of depressed tibial plateau fractures have centered on the creation of a cortical window and the use of a metallic bone tamp to elevate the depressed fragment. However, advocates for the use of more modern reduction techniques have argued that the hard metallic bone tamp can fracture the depressed articular fragment and penetrate the knee joint. In the past few years, alternative ways of controlled reduction of the depression using an inflatable balloon have been described. In this paper, we aim to describe the surgical technique of inflation osteoplasty for reduction of depressed tibial plateau fractures under direct arthroscopic visualization. We believe that the combination of percutaneous techniques of balloon osteoplasty and knee arthroscopy, to visualize and improve the quality of reduction, allows earlier range of motion following surgery, less swelling, lower pain level, and higher patient satisfaction.

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