Chirurgische Zugänge bei Tibiakopffrakturen

Chirurgische Zugänge bei Tibiakopffrakturen Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury pat- terns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture- specific access strategy is recommended to provide correct positioning of the plate osteosynthe- sis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e. g. posterolateral or posteromedial. If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be ana- tomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach. Keywords Classification · Minimally invasive surgery · Osteotomy · Patient positioning · Soft tissue injuries Der Unfallchirurg CME Abb. 1 9 Alternative Zugangswe- ge zur Darstellung der tibialen Ge- lenkfläche entsprechend der Zehn- segmentklassifikation. Weiß antero- medialer Zugang [18]; rot posterio- ALL ALZ AZ AMZ AMM rer/posteromedialer Zugang [15, 19, 20]; gelbanterolateralerZugang[18]; blau modifizierter posterolateraler Zugang [20]; grün erweiterter http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Der Unfallchirurg Springer Journals

Chirurgische Zugänge bei Tibiakopffrakturen

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Medizin Verlag GmbH, ein Teil von Springer Nature
Subject
Medicine & Public Health; Traumatic Surgery; Medicine/Public Health, general; Sports Medicine
ISSN
0177-5537
eISSN
1433-044X
D.O.I.
10.1007/s00113-018-0515-6
Publisher site
See Article on Publisher Site

Abstract

Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury pat- terns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture- specific access strategy is recommended to provide correct positioning of the plate osteosynthe- sis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e. g. posterolateral or posteromedial. If necessary, osteotomy of the femoral epicondyles can improve joint access for reduction control. Injuries to the posterior columns should be ana- tomically reconstructed and biomechanically correctly addressed via posterior approaches. Bony posterior cruciate ligament tears can be refixed via a minimally invasive posteromedial approach. Keywords Classification · Minimally invasive surgery · Osteotomy · Patient positioning · Soft tissue injuries Der Unfallchirurg CME Abb. 1 9 Alternative Zugangswe- ge zur Darstellung der tibialen Ge- lenkfläche entsprechend der Zehn- segmentklassifikation. Weiß antero- medialer Zugang [18]; rot posterio- ALL ALZ AZ AMZ AMM rer/posteromedialer Zugang [15, 19, 20]; gelbanterolateralerZugang[18]; blau modifizierter posterolateraler Zugang [20]; grün erweiterter

Journal

Der UnfallchirurgSpringer Journals

Published: Jun 6, 2018

References

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