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Type IV = Medial tibial plateau fracture, with or without depression; may involve tibial spines; associated soft tissue injuries. This is a medial tibial plateau fracture with a split or depressed component. It is usually the result of a high energy injury and involves a varus force with axial loading at the knee.
External fixation via TSFs tends to be less invasive than internal fixation and therefore has lower risks of infection associated with it. This is particularly relevant for open fractures. For open comminuted fractures of the tibial plateau the use of circular frames (like TSF) has markedly reduced infection rates. [2]
A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint.Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents.
The final step of reconstruction ligament fixation is the proximal tibial attachment of the sMCL. This soft-tissue attachment can be reproduced with a suture anchor [ 28 ] placed 12.2 mm distal to the medial joint line (average location), directly medial to the anterior arm of the semimembranosus tibial attachment. [ 27 ]
External fixation is a surgical treatment wherein Kirschner pins and wires are inserted and affixed into bone and then exit the body to be attached to an external apparatus composed of rings and threaded rods — the Ilizarov apparatus, the Taylor Spatial Frame, and the Octopod External Fixator — which immobilises the damaged limb to facilitate healing. [1]
In medicine, the Ilizarov apparatus is a type of external fixation apparatus used in orthopedic surgery to lengthen or to reshape the damaged bones of an arm or a leg; used as a limb-sparing technique for treating complex fractures and open bone fractures; and used to treat an infected non-union of bones, which cannot be surgically resolved.
Lesions in the tibial plateau, hip, ankle, and wrist are often missed. In a tibial plateau fracture, any disruption of the posterior and anterior cortical rims of the plateau should be sought. Impaction of subchondral bone will appear as an increased sclerosis of the subchondral bone (Figure 1).
Surgical treatment is typically indicated for high-energy trauma fractures. [ 1 ] Intramedullary nailing is a common technique, but external fixation may have equivalent outcomes and be preferred under certain patient conditions that may preclude intramedullary nailing, such as the presence of a total knee arthroplasty.