Department of Orthopaedic Surgery, Guro Hospital, Korea University College of Medicine, 80 Guro 2-dong, Guro-gu, 152-703 Seoul, Korea.
Arch Orthop Trauma Surg. 2012 Feb;132(2):233-7. doi: 10.1007/s00402-011-1409-z. Epub 2011 Oct 21.
With the introduction of 3.5 anatomically pre-shaped plates, the rafting screw technique is gaining popularity in recent years for the management of lateral tibial plateau fractures with articular depression. To gain access to the depressed articular fragments, the split fragment is hinged open laterally. We elevate the depressed articular fragments to the normal level. The defect below is filled with bone graft or its substitutes. We then close the split fragment and apply rafting screws either through the screw holes of the plate or separately above the plate rather in a blind fashion. We therefore cannot be sure that the rafting screws are supporting the specific elevated fragments. For this reason some surgeons place the rafting screws from within and then close the lateral fragment over the screws. This so-called embedded rafting screw technique carries the risk of difficulty in removal, especially in case of an infection. Here we describe the inside out rafting technique to tackle this problem.
随着 3.5 个解剖预成型钢板的引入，近年来，对于伴有关节面凹陷的胫骨平台外侧骨折，漂浮螺钉技术越来越受欢迎。为了接触到凹陷的关节碎片，将分裂的碎片向外侧铰链打开。我们将凹陷的关节碎片抬高到正常水平。下面的缺损用骨移植或其替代品填充。然后我们关闭分裂的碎片，并通过钢板上的螺钉孔或单独在钢板上方（而不是盲目地）施加漂浮螺钉。因此，我们不能确定漂浮螺钉是否支撑着特定抬高的碎片。出于这个原因，一些外科医生将漂浮螺钉从内部放置，然后将外侧碎片覆盖在螺钉上。这种所谓的嵌入式漂浮螺钉技术存在取出困难的风险，尤其是在感染的情况下。在这里，我们描述了一种内外侧结合的漂浮螺钉技术来解决这个问题。
