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"Out-in" position in the surgical treatment of three-column tibial plateau fractures: A technical note.

Authors
  • Zheng, Yang1
  • Zhang, Jiu-Dan2
  • Shen, Jian-Jian3
  • Huang, Jie-Feng4
  • 1 Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou 310006, China. Electronic address: [email protected] , (China)
  • 2 Department of Endocrinology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou 310006, China. Electronic address: [email protected] , (China)
  • 3 Department of Orthopaedics, Affiliated Cixi Hospital of Wenzhou Medical University, Cixi, China. Electronic address: [email protected] , (China)
  • 4 Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou 310006, China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
Injury
Publication Date
Apr 01, 2021
Volume
52
Issue
4
Pages
1074–1078
Identifiers
DOI: 10.1016/j.injury.2020.10.096
PMID: 33131792
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Three-column classification of tibial plateau fractures is based on computerized tomography (CT) images, and the patients with three-column fractures can be treated with posteromedial combined with anterolateral approach in the floating position. However, there are certain disadvantages to operating in a "floating position". Therefore, we proposed an "out-in" position for those fractures. The patient is placed in supine position on the operating table, and the healthy hip is elevated. For the posteromedial approach, the affected limb should be placed on a rectangular fluoroscopy table and kept in abduction and external rotation (out); for the anterolateral approach, the affected limb is retracted into the operating bed and kept in neutral position (in).This position has been shown to be highly effective for easy operation as well as intraoperative image monitoring. Furthermore, it highlights the advantage of anterior-posterior joint fracture reduction. Copyright © 2020 Elsevier Ltd. All rights reserved.

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