ORIF Tibial Tubercle Fracture



ORIF Tibial Tubercle Fracture


Mininder Kocher, MD, MPH







Patient Positioning (Figure 24-2)



  • Supine on the radiolucent table


  • Bump underneath ipsilateral buttocks to prevent patient external rotation







    Figure 24-2 ▪ Positioning of leg with elevation to allow for lateral fluoroscopic views.


  • Tourniquet


  • Set up for fluoroscopic AP and lateral views of the knee in order to confirm reduction and screw placement


  • radiolucent triangle


Surgical Approaches



  • Esmarch of the limb with elevation of the tourniquet


  • Direct anterior skin incision from the midpoint of patellar tendon proximally to 3 cm below the caudal end of tibia tubercle.


  • Significant soft tissue and periosteal stripping with a large hematoma will be encountered (Figure 24-3).


Reduction and Fixation Techniques



  • Reduction in these fractures is easily performed and can be aided by the following tricks:



    • Complete irrigation of the hematoma and cleaning of the fracture edges of any potential periosteum/soft tissue, which would block fracture edges coming together


    • Reduction done in extension with towel clamp pulling fracture distally


    • Adequacy of reduction is assessed by direct visualization of the cortical edges coming together (Figure 24-4)






      Figure 24-3 ▪ Intraoperative photo showing fracture site and soft tissue disruption.






      Figure 24-4 ▪ Intraoperative photo showing aided reduction via towel clamp.

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      Feb 5, 2020 | Posted by in ORTHOPEDIC | Comments Off on ORIF Tibial Tubercle Fracture
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