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Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,

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Presentation on theme: "Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,"— Presentation transcript:

1 Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein, and Michael D. McKee J Bone Joint Surg Am Volume 91(Supplement 2 Part 1):74-88 March 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

2 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

3 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

4 A preoperative computed tomography scan clarifies the main fracture lines. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

5 Patient positioning. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

6 Traction can be applied with use of either manual means, a femoral distractor, or, rarely, a fracture table. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

7 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

8 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

9 Following reduction of the articular surface, a fracture clamp is applied percutaneously. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

10 Initial application of the frame. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

11 Wire insertion. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

12 Fixation of the wires to the frame. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

13 Distal fixation of the fixator. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

14 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

15 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

16 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

17 Preoperative radiograph of a displaced bicondylar tibial plateau fracture in a thirty-two-year-old man. Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

18 Two operative approaches can be used: (1) a single anterior incision (left), which usually involves substantial soft-tissue stripping, or (2) the preferred two-incision approach (right). Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

19 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

20 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

21 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

22 Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88 ©2009 by The Journal of Bone and Joint Surgery, Inc.

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