Structural Bicortical Autologous Iliac Crest Bone Graft Combined with the Tunnel Bone Tamping Method for the Depressed Tibial Plateau Fractures

Figure 3

Steps of the reduction of the depressed articular fragments via TBTM and filling of the structural bicortical autologous iliac crest bone segment. (a) Knee CT scans of a 42-year-old man with DTPF; (b) a syringe needle was used to locate the articular cavity of the knee, and a 2.5 mm Kirschner wire was used to locate the position of the depressed area; (c) a power-driven trephine was used to create a bone tunnel on the anterior proximal tibia; (d) cylindrical metal tamps of different shapes and sizes; (e) retrograde reduction of the depressed articular fragments; (f) after reduction, cancellous bone was filled beneath the depressed articular fragments; (g)–(i) the structural bicortical autologous iliac crest bone segment was placed and compressed with a metal bone tamper. Then, reconstruction of the tibial cortical bone window was performed.

(a)

(b)

(c)

(d)

(e)

(f)

(g)

(h)

(i)