Thaunat Mathieu, Camelo Barbosa Nuno, Tuteja Sanesh, Jan Nicolas, Fayard Jean Marie, Sonnery-Cottet Bertrand
Générale de Santé Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France.
Arthrosc Tech. 2016 May 23;5(3):e507-11. doi: 10.1016/j.eats.2016.02.012. eCollection 2016 Jun.
This article aims to describe a simple and reliable technique that helps in positioning the cannulated percutaneous screws during fixation of depression-type tibial plateau fractures. After fracture reduction under arthroscopic control, an outside-in anterior cruciate ligament femoral guide is introduced through the tibial cortical metaphyseal window and positioned under endoscopic control just underneath the elevated fragment. When proper height is achieved, a guide pin is drilled from lateral to medial through the sleeve, 1 to 2 cm distal to the articular surface of the depressed fragment. The cannulated screw can then be introduced under endoscopic control, without fluoroscopic assistance, just under the previously elevated joint surface. This technique ensures optimal placement of the cannulated screw in the middle of the bony tunnel to obtain optimal subchondral bone support during fixation of the depressed tibial plateau fracture.
本文旨在描述一种简单可靠的技术，该技术有助于在治疗凹陷型胫骨平台骨折时定位空心经皮螺钉。在关节镜控制下进行骨折复位后，通过胫骨皮质干骺端窗口引入由外向内的前交叉韧带股骨导向器，并在内镜控制下将其放置在抬高的骨折块下方。当达到合适高度时，通过套筒从外侧向内侧钻入导针，位于凹陷骨折块关节面远端1至2厘米处。然后可以在内镜控制下，无需透视辅助，将空心螺钉引入到先前抬高的关节面下方。该技术可确保空心螺钉最佳地放置在骨隧道中部，以便在凹陷型胫骨平台骨折固定过程中获得最佳的软骨下骨支撑。
