Percutaneous Reduction of Tibial Plateau Depression Fractures: A New Technique

Signature Grand, Davie, Florida, USA

Objective. To present a novel percutaneous operative technique for tibial plateau depression fractures. Background. Tibial plateau fractures account for approximately 1% of all fractures. Using the Schatzker classification, type II and type III patterns account for the majority of fractures. True depression and split depression type fractures commonly occur from trauma involving an axial load with a valgus or varus deforming force. Historically, when surgical intervention is indicated, these fracture patterns have been treated with open reduction and internal fixation. Methods. We have developed a percutaneous method of reduction and fixation utilizing the Kyphon Inflatable Balloon Tamp. Our indications for surgical intervention with this technique include >3mm of depression, <5mm of>gapping, and >10° varus or valgus instability at 20° flexion. The complete technique is presented in the poster. Results. To date we have performed the technique on 6 patients. Four patients have had outcomes comparable to formal open reduction and internal fixation. Two patients have been lost to follow-up. Conclusions. The inflatable balloon tamp has been effective in a small group of patients for the reduction of pure depression and split depression tibial plateau fractures. Acknowledgement. Presented at the Annual Clinical Assembly of Osteopathic Specialists / American Osteopathic Academy of Orthopaedics. This poster won the 1st prize.