![Page 1: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/1.jpg)
Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau
Fractures
by Jeremy A. Hall, Murray J. Beuerlein, and Michael D. McKee
J Bone Joint Surg AmVolume 91(Supplement 2 Part 1):74-88
March 1, 2009
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/2.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/3.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/4.jpg)
A preoperative computed tomography scan clarifies the main fracture lines.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/5.jpg)
Patient positioning.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/6.jpg)
Traction can be applied with use of either manual means, a femoral distractor, or, rarely, a fracture table.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/7.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/8.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/9.jpg)
Following reduction of the articular surface, a fracture clamp is applied percutaneously.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/10.jpg)
Initial application of the frame.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/11.jpg)
Wire insertion.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/12.jpg)
Fixation of the wires to the frame.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 13: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/13.jpg)
Distal fixation of the fixator.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 14: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/14.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 15: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/15.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 16: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/16.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 17: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/17.jpg)
Preoperative radiograph of a displaced bicondylar tibial plateau fracture in a thirty-two-year-old man.
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 18: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/18.jpg)
Two operative approaches can be used: (1) a single anterior incision (left), which usually involves substantial soft-tissue stripping, or (2) the preferred two-incision approach (right).
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 19: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/19.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 20: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/20.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 21: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/21.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.
![Page 22: Open Reduction and Internal Fixation Compared with Circular Fixator Application for Bicondylar Tibial Plateau Fractures by Jeremy A. Hall, Murray J. Beuerlein,](https://reader035.vdocuments.site/reader035/viewer/2022062409/5697bfef1a28abf838cba48d/html5/thumbnails/22.jpg)
Jeremy A. Hall et al. J Bone Joint Surg Am 2009;91:74-88
©2009 by The Journal of Bone and Joint Surgery, Inc.