Ep.3: orthohub ODM: making sense of bicondylar tibial plateau fractures -educational video surgeons

Watch our third episode about making sense of bicondylar tibial plateau fractures in orthohub’s new #ODM series.
In this episode we build upon the previous two videos and discuss the use of x-rays and CT to understand complex bicondylar (Schatzker 5 & 6) tibial plateau fractures. In doing so, we talk about common fracture patterns and highlight just what to expect.
Once again, we take you through it step-by-step and demonstrate the key features on the plain radiographs, as well as on the coronal, sagittal, axial and 3D recon CT views. We share tips and tricks for patient positioning, fracture reduction, surgical approach and strategies for fracture fixation.
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Following great feedback, catch up on our first two ODM (orthopaedic decision making) videos in our channel. Stay tuned- there is more to come!
Leave a comment below about your favourite thing in this video, or if there is something you want us to cover!
#orthohub #educationvideoforsurgeons #orthopaedicsurgeons #orthopaedicdecisionmaking
About Us:
Founded by a group of orthopaedic surgeons, orthohub provides free innovative interactive orthopaedic education for all. At orthohub we want to shape the future of orthopaedic education through learning how and why decisions are made and the tips and tricks of operating. The art of surgery is more than just knowing how to do something, it's understanding why we do what we do, in order to get better results and outcomes for all of our patients. Learn more about orthohub at orthohub.xyz

[@HarshKumar-zx1ck]

Superb video

[@orthohubxyz]

Thanks Harsh, really appreciate you taking the time to leave a comment. Please do share with friends and colleagues!

[@julientrooper2536]

really useful!

[@orthohubxyz]

Glad it was helpful!

[@bluelight7752]

The first ct in which 2 butress plates were to b applied... Anteromedial and posteriorly......... That requires excessive dissection via postero medial approach...... Many times causing necrosis of anterior part of incision in this already complex closed injury........ So my question is how to prevent chance of flap necrosis in fractures which require anteromedial and posterior butress plating

[@peterbates1435]

That is a terrific question. As you say, the most a knee can happily tolerate is two major incisions and in the majority of situations (but not always) those two approaches are AL and PM. So what if you need an AM plate? In my hands, you make the AM approach very small and directly over the fracture site. So it might be just 3-4 cm long; just enough to see the fracture, push it closed and apply your buttress plate. The AM plate is then slid up and down to get it in and maybe fill up the proximal holes with stab incisions directly over the drill points. In general, for any bicondylar, my principle is, at the outset when planning, only allow yourself two proper-sized approaches - everything else has to be mipo/limited/ micro-approaches that just allow surgical access without creating a vulnerable skin bridge in (as you rightly say) a closed complex fracture. Love the question - thanks!

[@bluelight7752]

@@peterbates1435 thanks 🙂