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Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study

INTRODUCTION: The aim of this study was to compare the reduction quality of the anterolateral (AL) and modified posterolateral approach (PL) in lateral tibial plateau fractures involving the posterior column and central segments. METHODS: Matched pairs of pre-fractured cadaveric tibial plateau fract...

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Autores principales: Behrendt, Peter, Berninger, Markus T., Thürig, Grégoire, Dehoust, Julius, Christensen, Jan H., Frosch, Karl-Heinz, Krause, Matthias, Hartel, Maximilian J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925589/
https://www.ncbi.nlm.nih.gov/pubmed/36171336
http://dx.doi.org/10.1007/s00068-022-02113-8
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author Behrendt, Peter
Berninger, Markus T.
Thürig, Grégoire
Dehoust, Julius
Christensen, Jan H.
Frosch, Karl-Heinz
Krause, Matthias
Hartel, Maximilian J.
author_facet Behrendt, Peter
Berninger, Markus T.
Thürig, Grégoire
Dehoust, Julius
Christensen, Jan H.
Frosch, Karl-Heinz
Krause, Matthias
Hartel, Maximilian J.
author_sort Behrendt, Peter
collection PubMed
description INTRODUCTION: The aim of this study was to compare the reduction quality of the anterolateral (AL) and modified posterolateral approach (PL) in lateral tibial plateau fractures involving the posterior column and central segments. METHODS: Matched pairs of pre-fractured cadaveric tibial plateau fractures were treated by either AL approach (supine position) or PL approach (prone position). Reduction was controlled by fluoroscopy and evaluated as satisfying or unacceptable. Afterwards, the reduction was examined by 3D scan. RESULTS: 10 specimens (3 pairs 41B3.1, 2 pairs 41C3.3) were evaluated. PL approach achieved significantly (p 0.00472) better fracture reduction results (0.4 ± 0.7 mm) of the posterior column compared to the AL group (2.1 ± 1.4 mm). Fracture steps involving the central area of the lateral plateau were insufficiently reduced after fluoroscopy using both approaches. CONCLUSION: Optimal reduction of displaced tibial plateau fractures involving the posterolateral column necessitates a posterior approach, which can be conducted in prone or lateral positioning. The anterolateral approach is indicated in fractures with minor displacement of the posterolateral rim but fracture extension in the latero-central segments. In these cases, an additional video-assisted reduction or extended approaches are helpful.
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spelling pubmed-99255892023-02-15 Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study Behrendt, Peter Berninger, Markus T. Thürig, Grégoire Dehoust, Julius Christensen, Jan H. Frosch, Karl-Heinz Krause, Matthias Hartel, Maximilian J. Eur J Trauma Emerg Surg Original Article INTRODUCTION: The aim of this study was to compare the reduction quality of the anterolateral (AL) and modified posterolateral approach (PL) in lateral tibial plateau fractures involving the posterior column and central segments. METHODS: Matched pairs of pre-fractured cadaveric tibial plateau fractures were treated by either AL approach (supine position) or PL approach (prone position). Reduction was controlled by fluoroscopy and evaluated as satisfying or unacceptable. Afterwards, the reduction was examined by 3D scan. RESULTS: 10 specimens (3 pairs 41B3.1, 2 pairs 41C3.3) were evaluated. PL approach achieved significantly (p 0.00472) better fracture reduction results (0.4 ± 0.7 mm) of the posterior column compared to the AL group (2.1 ± 1.4 mm). Fracture steps involving the central area of the lateral plateau were insufficiently reduced after fluoroscopy using both approaches. CONCLUSION: Optimal reduction of displaced tibial plateau fractures involving the posterolateral column necessitates a posterior approach, which can be conducted in prone or lateral positioning. The anterolateral approach is indicated in fractures with minor displacement of the posterolateral rim but fracture extension in the latero-central segments. In these cases, an additional video-assisted reduction or extended approaches are helpful. Springer Berlin Heidelberg 2022-09-28 2023 /pmc/articles/PMC9925589/ /pubmed/36171336 http://dx.doi.org/10.1007/s00068-022-02113-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Behrendt, Peter
Berninger, Markus T.
Thürig, Grégoire
Dehoust, Julius
Christensen, Jan H.
Frosch, Karl-Heinz
Krause, Matthias
Hartel, Maximilian J.
Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title_full Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title_fullStr Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title_full_unstemmed Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title_short Anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
title_sort anterolateral versus modified posterolateral approach for tibial plateau fractures with involvement of the posterior column: a cadaveric study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9925589/
https://www.ncbi.nlm.nih.gov/pubmed/36171336
http://dx.doi.org/10.1007/s00068-022-02113-8
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