Die Fraktur der Gegenkortikalis bei der aufklappenden Osteotomie des Tibiakopfes

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• 作者：Dr. S. Schr?ter (1)
  A. Ateschrang (1)
  C. Ihle (1)
  U. St?ckle (1)
  L. Konstantinidis (2)
  S. D?bele (1)
  
• 关键词：Kortikalisfraktur ; laterale ; Knochenheilung ; Gonarthrose ; Endoprothetik ; Korrekturosteotomie ; Fracture of the lateral hinge ; Bone healing ; Gonarthrosis ; Endoprosthesis ; Correction osteotomy
• 刊名：Der Orthop?de
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：43
• 期：11
• 页码：1000-1007
• 全文大小：1,676 KB
• 参考文献：1. Coventry MB (1965) Osteotomy of the upper portion of the tibia for degenerative arthritis of the knee. A preliminary report. J Bone Joint Surg Am 47:984-90
  2. Bhandari M, Smith J, Miller LE, Block JE (2012) Clinical and economic burden of revision knee arthroplasty. Clin Med Insights Arthritis Musculoskelet Disord 5:89-4
  3. Floerkemeier S, Staubli AE, Schroeter S et al (2013) Outcome after high tibial open-wedge osteotomy: a retrospective evaluation of 533 patients. Knee Surg Sports Traumatol Arthrosc 21:170-80 CrossRef
  4. Saito T, Kamagai K, Akamatsu Y et al (2014) Five- to ten-year outcome following medial opening-wedge high tibial osteotomy with rigid plate fixation in combination with an artificial bone substitute. J Bone Joint Surg Br 96:339-44 CrossRef
  5. Cotic M, Vogt S, Hinterwimmer S et al (2014) A matched-pair comparison of two different locking plates for valgus-producing medial open-wedge high tibial osteotomy: peek-carbon composite plate versus titanium plate. Knee Surg Sports Traumatol Arthrosc (Epub ahead of print). doi:10.1007/s00167-014-2914-8
  6. Floerkemeier S, Staubli AE, Schroeter et al (2014) Does obesity and nicotine abuse influence the outcome and complication rate after open-wedge high tibial osteotomy? A retrospective evaluation of five hundred and thirty three patients. Int Orthop 38:55-0
  7. Staubli AE, Jacob HA (2010) Evolution of open-wedge high-tibial osteotomy: experience with a special angular stable device for internal fixation without interposition material. Int Orthop 34:167-72 CrossRef
  8. Niemeyer P, Schmal H, Hauschild O et al (2010) Open-wedge osteotomy using an internal plate fixator in patients with medial-compartment gonarthritis and varus malalignment: 3-year results with regard to preoperative arthroscopic and radiographic findings. Arthroscopy 26:1607-616 CrossRef
  9. Agneskirchner JD, Freiling D, Hurschler C, Lobenhoffer P (2006) Primary stability of four different implants for opening wedge high tibial osteotomy. Knee Surg Sports Traumatol Arthrosc 14:291-00 CrossRef
  10. Agneskirchner JD, Hurschler C, Stukenborg-Colsman C et al (2004) Effect of high tibial flexion osteotomy on cartilage pressure and joint kinematics: a biomechanical study in human cadaveric knees. Winner of the AGA-DonJoy Award 2004. Arch Orthop Trauma Surg 124:575-84 CrossRef
  11. Agneskirchner JD, Hurschler C, Wrann CD, Lobenhoffer P (2007) The effects of valgus medial opening wedge high tibial osteotomy on articular cartilage pressure of the knee: a biomechanical study. Arthroscopy 23:852-61 CrossRef
  12. Engel GM, Lippert FG 3rd (1981) Valgus tibial osteotomy: avoiding the pitfalls. Clin Orthop Relat Res 160:137-43
  13. Jung WH, Chun CW, Lee JH et al (2013) Comparative study of medial opening-wedge high tibial osteotomy using 2 different implants. Arthroscopy 29:1063-071 CrossRef
  14. Nelissen EM, van Langelaan EJ, Nelissen RG (2010) Stability of medial opening wedge high tibial osteotomy: a failure analysis. Int Orthop 34:217-23 CrossRef
  15. Schr?ter S, Gonser CE, Konstantinidis L et al (2011) High complication rate after biplanar open wedge high tibial osteotomy stabilized with a new spacer plate (Position HTO Plate) without bone substitute. Arthroscopy 27:644-52 CrossRef
  16. Osti M, Gohm A, Schlick B, Benedetto KP (2013) Complication rate following high tibial open-wedge osteotomy with spacer plates for incipient osteoarthritis of the knee with varus malalignment. Knee Surg Sports Traumatol Arthrosc (Epub ahead of print). doi:10.1007/s00167-013-2757-8 CrossRef
  17. Mart
• 作者单位：Dr. S. Schr?ter (1)
  A. Ateschrang (1)
  C. Ihle (1)
  U. St?ckle (1)
  L. Konstantinidis (2)
  S. D?bele (1)
  
  1. BG Unfallklinik Tübingen, Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universit?t Tübingen, Schnarrenbergstra?e 95, 72076, Tübingen, Deutschland
  2. Klinik für Orthop?die und Unfallchirurgie, Universit?tsklinikum Freiburg, Freiburg, Deutschland
  
• ISSN：1433-0431

文摘

Background Open wedge high tibial osteotomy (HTO) is an increasingly more common surgical method. A typical problem of this procedure is fracture of the lateral hinge. Objectives The aims of this article are to present the special issue of fractures of the lateral hinge after HTO and to discuss surgical hints on how to prevent and treat this problem. Methods The results of recently published clinical studies are summarized and tips from own clinical experiences are given. Results Type II fractures of the lateral hinge are unstable and can create a major problem. Using short spacer plates results in a problem of stability for all types of fractures. Conclusion The classification into Takeuchi grades I-III has been proven to be suitable for fractures of the lateral hinge. The TomoFix?plate is a safe implant to stabilize the osteotomy in type I and III fractures with which healing can be achieved with no problems. Type II fractures can be stabilized with the TomoFix?plate; however, an autologous bone graft has to be taken into consideration. For fractures of the lateral hinge short spacer plates are not recommended due to stability issues.