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Bennett KJ, Callary SA, Atkins GJ, Martelli S, Perilli E, Bogdan Solomon L, Thewlis D. Ex vivo assessment of surgically repaired tibial plateau fracture displacement under axial load using large-volume micro-CT. J Biomech 2022; 144:111275. [DOI: 10.1016/j.jbiomech.2022.111275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 10/31/2022]
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2
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Wang Z, Zheng Z, Ye P, Tian S, Zhu Y, Chen W, Hou Z, Zhang Q, Zhang Y. Treatment of tibial plateau fractures: A comparison of two different operation strategies with medium-term follow up. J Orthop Translat 2022; 36:1-7. [PMID: 35891925 PMCID: PMC9284320 DOI: 10.1016/j.jot.2022.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/13/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background The objective of this study was to compare the clinical and radiological outcomes of two surgical methods for tibial plateau fractures (TPFs): minimally invasive surgery (MIS) using a double reverse traction repositor and traditional open reduction internal fixation (ORIF). Methods From our prospectively collated database, 187 consecutive adult patients with 189 operatively treated TPFs in our level I trauma center were included from January 2015 to March 2018 who had a minimum of three years’ follow-up. All cases were performed by the senior surgeon using either MIS (group 1, 84 patients with 84 TPFs) or ORIF (group 2, 103 patients with 105 TPFs). Details of the demographics, injury mechanism, pre- and postoperative follow-up imaging, operative procedures and complications were collected. The final results from the 36-Item Short-Form Health Survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and Hospital for Special Surgery (HSS) were obtained at the final follow-up. Results Clinically, significant differences were observed in the WOMAC (pain, P = 0.001; stiffness, P < 0.001), HSS (P = 0.003) and SF-36 (P = 0.001). Radiologically, significant intergroup differences were observed in the loss of immediate postoperative reduction rates, secondary loss of reduction rates and signs of osteoarthritis (Kellgren–Lawrence). Two and ten superficial infections in group 1 (2.4%) and group 2 (9.5%), respectively, and 6 lateral popliteal nerve palsy cases occurred (0 MIS, 6 ORIF), with significant intergroup differences. Conclusion Our study shows that the MIS using a double reverse traction repositor is promising and safe technique for the TPFs when used for the correct indications. The translational potential of this article The current status of using a minimally invasive surgery for the treatment of TPFs have been analyzed and a new method of using a double reverse traction repositor for the treatment of TPFs have been proposed in this study, which updated treatment concept of TPFs.
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Affiliation(s)
- Zhongzheng Wang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Zhanle Zheng
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Pengyu Ye
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Siyu Tian
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yanbin Zhu
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Wei Chen
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Zhiyong Hou
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Qi Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, Hebei, 050051, People's Republic of China.,Chinese Academy of Engineering, Beijing, 100088, People's Republic of China
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3
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Vendeuvre T, Ferrière V, Bouget P, Billot M, Germaneau A, Severyns M, Roulaud M, Rigoard P, Pries P. Percutaneous surgery with balloon for tibial plateau fractures, results with a minimum of 5 years of follow-up. Injury 2022; 53:2650-2656. [PMID: 35643555 DOI: 10.1016/j.injury.2022.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/22/2022] [Accepted: 05/14/2022] [Indexed: 02/02/2023]
Abstract
Tibial plateau fracture is a frequent entity for which surgical management is difficult both surgically and postoperatively, with multiple complications and often delayed recovery. The challenge lies in the anatomical reduction of the joint, the limitation of complications and the rapid functional recovery. Tuberoplasty appears to be an innovative technique that meets current expectations. The objective is to evaluate the reliability of tuberoplasty in reducing surgical risks and improving postoperative clinical results. This single-centre retrospective study included 30 patients with depressed tibial plateau fractures who underwent tuberoplasty from September 2011 to March 2014. Reduction analysis was performed by comparing pre-operative and post-operative depression from computed tomography (CT) data. Clinical outcomes were assessed by measuring flexion joint ranges, time to weight-bearing, KOOS questionnaire and a pangonogram. The mean depression was 7.4mm pre-operatively and 2.6mm [0;9] post-operatively, with 47% (14/30) having a residual depression of 2mm or less. Mean flexion at 6 weeks was 103° [30; 130]. Partial and total weight-bearing were allowed on day 47 [3; 150] and day 58 [20; 150], respectively. The mean KOOS score was 25.43 [1.15; 62.30] at a minimum of 5 years after surgery and the mean axis was 176.54° [172; 180]. There was one case of thrombophlebitis and one sensory-motor deficit in the common fibular nerve territory. The reduction of the tibial plateau observed in our study from tuberoplasty is in line with the literature results obtained from a conventional approach. Our results indicate that tuberoplasty is stable in the long term, has good functional results and early recovery with few complications. This preliminary study presents results that need to be investigated in a prospective randomised double-blind study.
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Affiliation(s)
- Tanguy Vendeuvre
- CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France; Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, France
| | - Victor Ferrière
- CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France.
| | - Pierre Bouget
- CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France
| | - Maxime Billot
- CHU de Poitiers, 2 rue de la Milétrie, PRISMATICS (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86021 Poitiers, France
| | - Arnaud Germaneau
- CHU de Poitiers, 2 rue de la Milétrie, PRISMATICS (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86021 Poitiers, France
| | - Mathieu Severyns
- Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, France
| | - Manuel Roulaud
- CHU de Poitiers, 2 rue de la Milétrie, PRISMATICS (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86021 Poitiers, France
| | - Philippe Rigoard
- CHU de Poitiers, 2 rue de la Milétrie, PRISMATICS (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), 86021 Poitiers, France
| | - Pierre Pries
- CHU de Poitiers, 2 rue de la Milétrie, Service d'Orthopédie-Traumatologie et Chirurgie de la Colonne, 86021 Poitiers, France
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Vendeuvre T, Koneazny C, Brèque C, Rigoard P, Severyns M, Germaneau A. Contribution of Minimally Invasive Bone Augmentation With PMMA Cement in Primary Fixation of Schatzker Type II Tibial Plateau Fractures. Front Bioeng Biotechnol 2022; 10:840052. [PMID: 35299640 PMCID: PMC8921932 DOI: 10.3389/fbioe.2022.840052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/02/2022] [Indexed: 11/17/2022] Open
Abstract
Background: The most common type of fracture of the lateral tibial plateau is the Schatzker type II split-depressed fracture. Minimally invasive surgery using balloon reduction appears to be very promising compared to the gold standard using a bone tamp. This surgery aims to have the best reduction and stabilization to benefit from an early passive and active rehabilitation to avoid stiffening and muscle wasting. Using a balloon for fracture reduction has allowed the use of semi-liquid Injectable Bone Cement (IBC) fillers. These fillers can be phosphocalcic or polymethyl methacrylate (PMMA). The latest recommendations on these IBCs in spinal surgery increasingly rule out phosphocalcic fillers because of their low mechanical strength. Questions/purposes: 1) What is the mechanical influence of IBC filling (PMMA) regarding the split and depression components of a Schatzker type II fracture? 2) What is the mechanical influence of osteosynthesis regarding the split and depression components of a Schatzker type II fracture with or without PMMA filing in three different kinds of percutaneous fixations? Methods: This biomechanical study was performed on 36 fresh frozen tibia/fibula specimens. Six groups were formed according to the type of percutaneous osteosynthesis or possible PMMA filling. Mechanical strength tests were carried out using a Unicompartmental Knee prosthesis and displacement components were measured on either side of the separation on the anterolateral facet by optical method. Results: We found a significant difference between cementless and cemented osteosynthesis for depression fracture stabilization (difference −507.56N with 95% confidence interval [−904.17; −110.94] (p-value = 0.026)). The differences between the different types of osteosynthesis were not significant (p-value = 0.58). There was a significant difference between osteosynthesis without cement and osteosynthesis with cement on separation (difference −477.72N [−878.52; −76.93] (p-value = 0.03)). The differences between the different types of fixations were not significant regarding separation (p-value = 0.99). Conclusion: PMMA cement significantly improves primary stability, regardless of the type of osteosynthesis for a Schatzker type II plateau fracture. Filling with PMMA cement during tuberoplasty seems to be a very promising strategy in association with percutaneous osteosynthesis to allow rapid recovery after surgery.
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Affiliation(s)
- T. Vendeuvre
- Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France
- Department of Orthopaedic Surgery and Traumatology, University Hospital, Poitiers, France
| | - C. Koneazny
- Department of Orthopaedic Surgery and Traumatology, University Hospital, Poitiers, France
| | - C. Brèque
- Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France
| | - P. Rigoard
- Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France
- PRISMATICS Lab, Department of Spine Surgery and Neuromodulation, University Hospital, Poitiers, France
| | - M. Severyns
- Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France
- Department of Orthopaedic Surgery and Traumatology, University Hospital, Martinique, France
| | - A. Germaneau
- Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, Université de Poitiers, Poitiers, France
- *Correspondence: A. Germaneau,
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Unilateral locking plate versus unilateral locking plate combined with compression bolt for Schatzker I-IV tibial plateau fractures: a comparative study. INTERNATIONAL ORTHOPAEDICS 2022; 46:1133-1143. [PMID: 35106670 DOI: 10.1007/s00264-022-05324-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The quality and durability of fracture reduction play an important role in the functional prognosis of articulation. The purpose of this study was to investigate the radiological and clinical effects of compression bolts in the treatment of Schatzker I-IV tibial plateau fractures (TPFs). METHODS Between May 2015 and April 2018, a total of 96 consecutive adult patients with operatively treated Schatzker I-IV TPFs were included and divided into two groups according to the internal fixations: Group 1 (unilateral locking plate) and Group 2 (unilateral locking plate combined with compression bolt). Data on demographic and fracture characteristics, postoperative follow-up imaging, intraoperative indicators, postoperative reduction quality and durability, clinical outcomes, and complications were retrospectively collected and compared between the two groups. RESULTS There were no significant intergroup differences in preoperative baseline data, duration of operation, intra-operative blood loss, days in hospital, rate of immediate post-operative reduction loss, or complications. The time of fracture healing, the rate of secondary reduction loss, and the mean WOMAC score were significantly reduced compared with those in Group 1 (P = 0.024, 0.015, and 0.024, respectively). There were significant intergroup differences in the mean HSS score (89.0 ± 11.4 vs. 94.4 ± 6.7, P = 0.042), the mean Lysholm score (83.8 ± 9.6 vs. 88.4 ± 5.2, P = 0.027), and the mean SF-36 score (82.8 ± 12.5 vs. 90.5 ± 7.6, P = 0.001). Additionally, there were similar significant differences in subgroup analysis (only included patients with Schatzker II-III), except for WOMAC score. CONCLUSION Compared with unilateral locking plate fixation, unilateral locking plate combined with compressing bolt fixation can reduce the rate of secondary reduction loss, accelerate fracture healing, and show better clinical outcomes for patients with Schatzker I-IV TPFs.
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Aubert K, Germaneau A, Rochette M, Ye W, Severyns M, Billot M, Rigoard P, Vendeuvre T. Development of Digital Twins to Optimize Trauma Surgery and Postoperative Management. A Case Study Focusing on Tibial Plateau Fracture. Front Bioeng Biotechnol 2021; 9:722275. [PMID: 34692655 PMCID: PMC8529153 DOI: 10.3389/fbioe.2021.722275] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background and context: Surgical procedures are evolving toward less invasive and more tailored approaches to consider the specific pathology, morphology, and life habits of a patient. However, these new surgical methods require thorough preoperative planning and an advanced understanding of biomechanical behaviors. In this sense, patient-specific modeling is developing in the form of digital twins to help personalized clinical decision-making. Purpose: This study presents a patient-specific finite element model approach, focusing on tibial plateau fractures, to enhance biomechanical knowledge to optimize surgical trauma procedures and improve decision-making in postoperative management. Study design: This is a level 5 study. Methods: We used a postoperative 3D X-ray image of a patient who suffered from depression and separation of the lateral tibial plateau. The surgeon stabilized the fracture with polymethyl methacrylate cement injection and bi-cortical screw osteosynthesis. A digital twin of the patient’s fracture was created by segmentation. From the digital twin, four stabilization methods were modeled including two screw lengths, whether or not, to inject PMMA cement. The four stabilization methods were associated with three bone healing conditions resulting in twelve scenarios. Mechanical strength, stress distribution, interfragmentary strains, and fragment kinematics were assessed by applying the maximum load during gait. Repeated fracture risks were evaluated regarding to the volume of bone with stress above the local yield strength and regarding to the interfragmentary strains. Results: Stress distribution analysis highlighted the mechanical contribution of cement injection and the favorable mechanical response of uni-cortical screw compared to bi-cortical screw. Evaluation of repeated fracture risks for this clinical case showed fracture instability for two of the twelve simulated scenarios. Conclusion: This study presents a patient-specific finite element modeling workflow to assess the biomechanical behaviors associated with different stabilization methods of tibial plateau fractures. Strength and interfragmentary strains were evaluated to quantify the mechanical effects of surgical procedures. We evaluate repeated fracture risks and provide data for postoperative management.
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Affiliation(s)
- Kévin Aubert
- Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France.,Ansys France, Villeurbanne, France
| | - Arnaud Germaneau
- Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France
| | | | | | - Mathieu Severyns
- Department of Orthopedic and Trauma Surgery at the University Hospital Center of Fort-de-France, Fort-de-France, France
| | - Maxime Billot
- PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Philippe Rigoard
- Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France.,PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France.,Department of Spine Surgery and Neuromodulation, Poitiers University Hospital, Poitiers, France
| | - Tanguy Vendeuvre
- Institut Pprime UPR 3346, CNRS - Université de Poitiers - ISAE-ENSMA, Poitiers, France.,PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France.,Department of Spine Surgery and Neuromodulation, Poitiers University Hospital, Poitiers, France.,Department of Orthopedic Surgery and Traumatology, Poitiers University Hospital, Poitiers, France
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7
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Vendeuvre T, Gayet LÉ. Percutaneous treatment of tibial plateau fractures. Orthop Traumatol Surg Res 2021; 107:102753. [PMID: 33316447 DOI: 10.1016/j.otsr.2020.102753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
In France, 11,294 proximal tibia fractures occurred in 2018 and 6880 surgical procedures were done to treat them. Most of these were tibial plateau fractures, although fractures can occur in the metaphysis only or in the intercondylar eminence. The proximal tibia's poor vascularization justifies sparing it by doing a percutaneous treatment, setting the stage for bone union. The treatment must be based on rigorous planning with 3D imaging to determine the type of fracture accurately. The goals of treatment are first to realign the lower limb and then to reduce the articular surface, while addressing any associated injuries. Percutaneous reduction is based on ligamentotaxis and the use of spatulas or balloons that spare the vascularization. Surgical navigation and arthroscopy are precious tools for verifying the reduction. There are several options for stabilization, ranging from using polymethylmethacrylate cement for a Schatzker III fracture to applying a cannulated screw or doing MIPPO (Minimal Invasive Percutaneous Plate Osteosynthesis) with an anatomical plate and adjustable locking screws placed under the depression in complex fractures. Percutaneous surgery is not about the size of the incisions; the focus is on sparing the metaphysis and its vascularization to ensure high-quality and long-lasting stability. It appears to yield better functional outcomes than open reduction and internal fixation, not only for Schatzker type I, II and III fractures, but also for complex fractures where open fixation is more damaging and the source of complications.
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Affiliation(s)
- Tanguy Vendeuvre
- Service de chirurgie orthopédique et traumatologique, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - Louis-Étienne Gayet
- Service de chirurgie orthopédique et traumatologique, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
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Giordano V, Pires RE, Kojima KE, Fischer ST, Giannoudis PV. Subchondral Rafting Plate for the Treatment of Fragmented Articular Central Depression Tibial Plateau Fracture Patterns: Case Series and Technical Illustration. Cureus 2021; 13:e12740. [PMID: 33643720 PMCID: PMC7884057 DOI: 10.7759/cureus.12740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 11/05/2022] Open
Abstract
Articular depression is a significant component of lateral tibial plateau fracture patterns. Current literature supports the use of subchondral rafting screws, either placed through a plate or not. However, articular comminution has been associated with increased articular subsidence despite an adequate screw-joint distance. We report four cases that underwent the subchondral rafting plate technique for fragmented articular central depression lateral tibial plateau fractures. Clinical and radiographic evaluations were performed at the last follow-up. The mean follow-up was 18 months. All patients healed the fracture without any significant articular subsidence or loss of reduction. This case study hints that this novel technique is a potentially safe and cost-effective strategy to be incorporated in the daily practice of the orthopedic trauma surgeon, especially in certain challenging circumstances when a salvage procedure is required due to lateral tibial plateau fracture malreduction and the unavailability of anatomically designed locking plates.
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Affiliation(s)
- Vincenzo Giordano
- Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto (HMMC), Rio de Janeiro, BRA
| | - Robinson E Pires
- Departamento de Ortopedia, Universidade Federal de Minas Gerais, Belo Horizonte, BRA
| | - Kodi E Kojima
- Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo (HCFMUSP), São Paulo, BRA
| | - Sergei T Fischer
- Departamento de Ortopedia, Hospital do Trabalhador, Universidade Federal do Paraná, Curitiba, BRA
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Aubert K, Vendeuvre T, Michel N, Rochette M, Brèque C, Rigoard P, Valle V, Germaneau A. Characterization of bone fragment displacement during minimally invasive surgical procedures by digital volume correlation (DVC). Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1811495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kévin Aubert
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- ANSYS FRANCE, Villeurbanne, France
| | - Tanguy Vendeuvre
- ABS Lab, Université de Poitiers, Poitiers, France
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | - Nicolas Michel
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | | | - Cyril Brèque
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- ABS Lab, Université de Poitiers, Poitiers, France
| | - Philippe Rigoard
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | - Valéry Valle
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - Arnaud Germaneau
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
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10
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Dong XP, Zhang YW, Pei YJ, Wang Z, Zhang XX, Yu XL, Ai ZZ, Mei YX, Li JN. Three-dimensional printing for the accurate orthopedics: clinical cases analysis. Biodes Manuf 2020. [DOI: 10.1007/s42242-020-00070-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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11
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Vendeuvre T, Monlezun O, Brandet C, Ingrand P, Durand-Zaleski I, Gayet LE, Germaneau A, Khiami F, Roulaud M, Herpe G, Rigoard P. Comparative evaluation of minimally invasive 'tibial tuberoplasty' surgical technique versus conventional open surgery for Schatzker II-III tibial plateau fractures: design of a multicentre, randomised, controlled and blinded trial (TUBERIMPACT study). BMJ Open 2019; 9:e026962. [PMID: 31481365 PMCID: PMC6731842 DOI: 10.1136/bmjopen-2018-026962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Fractures of the tibial plateau are in constant progression. They affect an elderly population suffering from a number of comorbidities, but also a young population increasingly practicing high-risk sports. The conventional open surgical technique used for tibial plateau fractures has several pitfalls: bone and skin devascularisation, increased risks of infection and functional rehabilitation difficulties. Since 2011, Poitiers University Hospital is offering to its patients a new minimally invasive technique for the reduction and stabilisation of tibial plateau fractures, named 'tibial tuberoplasty'. This technique involves expansion of the tibial plateau through inflation using a kyphoplasty balloon, filling of the fracture cavity with cement and percutaneous screw fixation. We designed a study to evaluate the quality of fracture reduction offered by percutaneous tuberoplasty versus conventional open surgery for tibial plateau fracture and its impact on clinical outcome. METHODS AND ANALYSIS This is a multicentre randomised controlled trial comparing two surgical techniques in the treatment of tibial plateau fractures. 140 patients with a Schatzker II or III tibial plateau fracture will be recruited in France. They will be randomised either in tibial tuberoplasty arm or in conventional surgery arm. The primary outcome is the postoperative radiological step-off reduction blindly measured on CT scan (within 48 hours post-op). Additional outcomes include other radiological endpoints, pain, functional abilities, quality of life assessment and health-economic endpoints. Outcomes assessment will be performed at baseline (before surgery), at day 0 (surgery), at 2, 21, 45 days, 3, 6, 12 and 24 months postsurgery. ETHICS AND DISSEMINATION This study has been approved by the ethics committee Ile-De-France X and will be conducted in accordance with current Good Clinical Practice (GCP) guidelines, Declaration of Helsinki and standard operating procedures. The results will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER Clinicaltrial.gov:NCT03444779.
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Affiliation(s)
- Tanguy Vendeuvre
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Spine and Neuromodulation Functional Unit, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- ABS Lab, Poitiers University, Poitiers, France
- Institut Pprime, Futuroscope, Poitou-Charentes, France
| | - Olivier Monlezun
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Claire Brandet
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Pierre Ingrand
- UFR Medecine et Pharmacie, Universite de Poitiers, Poitiers, France
| | | | - Louis-Etienne Gayet
- Department of Orthopaedic Surgery and Traumatology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | | | - Frederic Khiami
- Department of Orthopaedic Surgery and Traumatology, Hopitaux Universitaires Pitie Salpetriere-Charles Foix, Paris, France
| | - Manuel Roulaud
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Guillaume Herpe
- Department of Radiology, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Philippe Rigoard
- Prismatics Lab, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- Spine and Neuromodulation Functional Unit, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
- ABS Lab, Poitiers University, Poitiers, France
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Michel N, Aubert K, Germaneau A, Gayet LE, Valle V, Brèque C, Rigoard P, Vendeuvre T. Surface analysis during surgical balloon reduction of a tibial Plateau depression fracture. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- N. Michel
- Pédiatrie - Chirurgie orthopédique, traumatologique et plastique, Hôpital des enfants, CHU Toulouse, Toulouse, France
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Spine & Neuromodulation Function Unit. PRISMATICS Lab CHU – Poitiers, Poitiers, France
| | - K. Aubert
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - A. Germaneau
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - L.-E Gayet
- Chirurgie orthopédique-traumatologie, CHU Poitiers, Poitiers, France
| | - V. Valle
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - C. Brèque
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - P. Rigoard
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Chirurgie orthopédique-traumatologie, CHU Poitiers, Poitiers, France
| | - T. Vendeuvre
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Chirurgie orthopédique-traumatologie, CHU Poitiers, Poitiers, France
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Vendeuvre T, Brèque C, Severyns M, Ounajim A, Richer JP, Rigoard P, Germaneau A. Interest of PMMA filing to primary stabilization of the minimaly invasive osteosynthesis of schatzker type II tibial Plateau fractures. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- T. Vendeuvre
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- ABS Lab Université de Poitiers, Poitiers, France
- Spine & Neuromodulation Function Unit. PRISMATICS Lab CHU, Poitiers, France
| | - C. Brèque
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- ABS Lab Université de Poitiers, Poitiers, France
| | - M. Severyns
- Service de chirurgie orthopédique-Fort de France, Fort de France, France
| | - A. Ounajim
- Spine & Neuromodulation Function Unit. PRISMATICS Lab CHU, Poitiers, France
| | - J.-P. Richer
- ABS Lab Université de Poitiers, Poitiers, France
| | - P. Rigoard
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Spine & Neuromodulation Function Unit. PRISMATICS Lab CHU, Poitiers, France
| | - A. Germaneau
- ABS Lab Université de Poitiers, Poitiers, France
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