Aches & Joints

Mark S Vrahas, MD, Partners Chief of Orthopaedic Trauma, and Associate Professor of Orthopaedic Surgery at Harvard Medical School, describes a new way to fix tibial tubercle fractures. Dr Vrahas sees patients at the Brigham & Women’s Hospital, and the Massachusetts General Hospital.

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A fracture of the tibial tubercle when associated with a fracture of the tibial plateau often disrupts the extensor mechanism and can be difficult to manage. Traditionally, tibial tubercle fractures have been repaired by lagging the tubercle fragment to the posterior cortex of the tibia. However, the screws do not get adequate purchase, particularly in comminuted or osteoporotic bone. Over several years we successfully stabilized such tubercle fractures using a simple wiring technique. Here, the tibial tubercle fragment is stabilized by wiring it directly to the screws of a locking plate. Our preliminary results using this new technique have demonstrated a high rate of clinical and radiographic union, with near normal return of extensor mechanism function.
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Filed under: Knee, Orthopaedic, Trauma, Trauma Rounds | Tagged: BWH, cerclage wires, fixation, fractures, Mass General, MGH, Partners Healthcare, Tibia, tibial plateau fracture, tibial tubercle, wiring | Leave a Comment »