Multifragmentary Fracture of the Tibial Plafond (High-Energy Trauma)

The treatment of high-energy multifragmentary fractures of the tibial plafond represents a significant technical challenge for orthopedic surgeons. This training offers a technical immersion in the osteosynthesis of these injuries, addressing everything from surgical planning to the management of complex fragments and the use of minimally invasive techniques, presented from a surgical perspective.

Training Focus:

• Management of multifragmentary tibial plafond fractures with high-energy trauma.
• Fibula stabilization techniques.
• Reduction and fixation of intermediate fragments and joint depressions.
• Minimally invasive surgical approaches for tibial plafond.
• Strategic use of different implants (plates, screws) for optimization of osteosynthesis.

Detailed Content:

• Optimized Surgical Planning: Protocols for the evaluation of multifragmentary fractures and selection of approaches.
• Fibula Fixation Technique: Methodology for alignment and stabilization of the fibula via minimally invasive access and percutaneous screws, essential for the reduction of the tibial plafond.
• Precise Reduction of Segmental Fragments: Detailed approach for exposure, reduction, and fixation of complex fragments, using a lag screw as a vector and an anti-shear plate for primary stability.
• Controlled Distal Anteromedial Access: Methodology for creating a surgical corridor that preserves vascular structures (saphenous vein) and soft tissues, minimizing the risk of skin necrosis.
• Management of Joint Depressions: Techniques for decompression and fixation of depressed fragments, including the use of retrograde screws and strategies for anatomical closure of the joint.
• Effective Medial Plating: Strategies for creating a submuscular tunnel and inserting a long anatomical plate, complemented by cannulated screws for posterior malleolar fixation and additional anti-shear plates.
• Optimized Closure: Techniques for periosteal closure over the plate, protecting the implant and maintaining tissue vascularization.
• Anatomical Outcome and Stability: Demonstration of the final result with congruent joint reduction and multiplanar stabilization.

Included Material:

• Detailed PDF: Technical document summarizing the surgical treatment of multifragmentary tibial plateau fractures, addressing the initial and definitive phases. It includes surgical planning focused on the fibula, posteromedial fragment, and anterior depression, with descriptions of minimally invasive approaches, fixation techniques, medial plating, and periosteal closure for plate protection and maintenance of vascularization.

Enhance your expertise in trauma surgery. Enroll now and master effective strategies in the treatment of multifragmentary tibial plateau fractures.