Inflation osteoplasty for the reduction of depressed tibial plateau fractures: description of a new technique

Current techniques for the reduction of depressed tibial plateau fractures are difficult and often imprecise. Treatment goals are centered on restoring the native anatomy and articular congruency. Reduction methods currently consist of manually elevating any depressed fragments and filling the subsequent void. Current instruments are imprecise and considerable variability exists as to acceptable reduction limits. Often the void is small and insufficient space available for bone filler to provide adequate support. Recently, we have begun using an inflatable bone tamp for the reduction of depressed tibial plateau fractures. The concept is built upon the success of the tamp in kyphoplasty of the spine, but it has yet to be described for use in the extremities. We describe a technique for percutaneous reduction of depressed articular fragments using the inflatable tamp. It is safe and effective and offers the benefit of minimizing soft tissue trauma and creating an expanded void to be filled with graft or other bone substitute.