ORIF Tibial Tubercle Fracture
Mininder Kocher, MD, MPH
Displaced tibial tubercle fracture (Figure 24-1)
4.5 mm or 6.5 mm cannulated screws with washers
radiolucent fracture table
Patient Positioning (Figure 24-2)
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)