ABSTRACT
OBJECTIVE: To report the initial results from the use of a new technique for fixation of bone grafts in uncontained tibial bone defects in patients undergoing total knee prosthesis implantation. METHODS: Six patients with severe varus deformity of the knee who, after cuts and ligament balancing had been performed, still presented bone deficiencies that reached the edge of the tibial cut and compromised the implant stability, underwent a new fixation technique. RESULTS: Five of the patients had good-clinical results, with integration of the graft within 12 weeks. One patient presented clinical complications with wound dehiscence and implant exposure, which evolved to the need for implant removal and knee arthrodesis. CONCLUSION: Support osteosynthesis as a graft fixation method is a viable option for treating tibial bone deficiencies. The proposed technique certainly needs further studies for its validation.
ABSTRACT
Tibial plateau fractures are joint lesions that require anatomical reduction of joint surface and functional restoration of mechanical axis of a lower limb. Patient profile, soft tissue conditions, presence of associated injuries and the available infrastructure for the treatment all contribute to the decision making about the best treatment for these fractures. High-energy fractures are usually approached in a staged manner respecting the principle of damage control, and are primarily targeted to maintain limb alignment while the resolution unfavorable soft tissue conditions is pending. Low-energy trauma can be managed on a singlestage basis, provided soft tissues are not an adverse factor, with open reduction and internal fixation. Stable fixation and early painless joint movement are related to a better prognosis. New developments as locked plates, bone replacements, intraoperative 3D imaging are promising and will certainly contribute for less invasive procedures and better outcomes.
