Use of a Mineral Bone Substitute in Tibial Plateau Fractures

摘要

Optimal treatment of tibial plateau fractures remains a controversial aspect of traumatology. We have used a minimally invasive technique of percutaneous elevation and osteosynthesis for unicondylar (AO type B2 and B3) fractures achieving good reduction, stable fixation and early mobilisation. Undoubtedly, there remains a cancellous bone gap following the traumatic crushing and this compromises the stability for 2-3 months. There is no consensus as how to fill this gap and render the system more stable and shorten the anatomical and functional recovery. A new mineral bone substitute, NORIAN SRS (Skeletal Repair System) could fulfil this role: it is injected into the cancellous bone gap as a paste. It hardens in a few minutes and reaches a bone-like mechanical strength by 12 hours. We have treated 20 unicondylar type B2 and B3 tibial plateau fractures. The patients were fourteen females and six males ranging in age from 37 to 69 years (mean age 51). We reviewed all the patients after mean follow up of fourteen months. According to one of the most common systems for clinical evaluation of the knee, 10 patients were graded excellent (50 percent), 4 patients were graded good (20 percent), 4 patients were graded fair (20 percent), and 2 were graded as poor (10 percent). We intend to demonstrate, with cases and discussion, the main advantages of NORIAN SRS as an adjunct to traditional surgical technique, both during reduction and osteosynthesis, and then during postoperative management.