Dr. Ebraheim’s educational animated video describes treatment of Tibial Plateau Depression Fracture with Balloon Osteoplasty Surgery.
A tibial plateau depression fractures occurs when axial forces from the femoral condyles against the articular surface of the tibia causes the injury. The compression fracture may also be associated with other fractures.
Several techniques are used for treatment of this fracture. Balloon osteoplasty is proposed as a useful tool for reduction and elevation of the tibial plateau depression fracture. The technique of balloon osteoplasty can be done with or without the supplementation of screws and plate fixation. X-ray showing the area of depression.
Technique
Trajectory lines are drawn on the medial side of the knee for access to the fracture area. A small incision is made at the point where the line cross.
A cannula and trocar tip stylet is used to access the fractured area under radiographic guidance. The cannula na trocar is advanced under the area of depression using a mallet or drill when needed.
The trocar is then removed from the cannula.
The precision drill is then inserted into the cannula and advanced until it passes under the depressed area of bone. Patient example of precision drilling into the bone.
The precision drill is next removed from the cannula.
The inflatable bone tamp is then inserted through the cannula to the area of the depressed fragments.
The inflatable bone tamp is centered under the area of depression and then inflated to reduce the depression fracture. Patient example of reducing the fracture depression using the inflatable bone tamp.
Once the depression has been adequately reduced, the inflatable bone tamp can be deflated and removed from the cannula. The void that has been left by the inflatable bone tamp is now ready to be replaced with bone filler. The device loaded with injectable material is inserted and used until the void is completely filled.
x-ray showing the defect before reduction. X-ray showing the filled area of injectable material.
Finally remove the injectable material device and the cannula.
Plate fixation may be added before or after the injectable material is inserted.

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