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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