J Knee Surg 2014; 27(01): 031-038
DOI: 10.1055/s-0033-1363516
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Balloon Tibioplasty: Pearls and Pitfalls

Cyril Mauffrey
1   Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, Colorado
,
Gareth Roberts
1   Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, Colorado
,
Derly O. Cuellar
1   Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, Colorado
,
Benoit Herbert
1   Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, Colorado
,
David Hak
1   Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado, School of Medicine, Denver, Colorado
› Author Affiliations
Further Information

Publication History

28 October 2013

01 November 2013

Publication Date:
13 December 2013 (online)

Abstract

Methods of tibial plateau fracture fixation have evolved over the last decades; however the techniques used to reduce these fractures have remained relatively unchanged. Balloon tibioplasty, a minimally invasive novel technique used in the reduction of depressed tibial plateau fractures, has been gaining popularity. This technique offers a slow controlled expansion of the balloon with multidirectional force vectors and a large surface area allowing for more bone to be elevated simultaneously. The technique also creates a well-defined bone void of known volume while theoretically compressing the surrounding bone, potentially limiting the risk of cement extrusion as well as late subsidence of the elevated bone. Although an attractive option, as with all novel techniques there is a learning curve. The purpose of this article is to briefly describe our technique of balloon tibioplasty, potential contraindications, and to illustrate some possible complications, and provide some tips and tricks we have found useful to avoid them.

 
  • References

  • 1 Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury 2006; 37 (8) 691-697
  • 2 Broome B, Mauffrey C, Statton J, Voor M, Seligson D. Inflation osteoplasty: in vitro evaluation of a new technique for reducing depressed intra-articular fractures of the tibial plateau and distal radius. J Orthop Traumatol 2012; 13 (2) 89-95
  • 3 Mauffrey C, Fader R, Hammerberg EM, Hak DJ, Stahel PF. Incidence and pattern of technical complications in balloon-guided osteoplasty for depressed tibial plateau fractures: a pilot study in 20 consecutive patients. Patient Saf Surg 2013; 7 (1) 8
  • 4 Boonen S, Wahl DA, Nauroy L , et al; CSA Fracture Working Group of International Osteoporosis Foundation. Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures. Osteoporos Int 2011; 22 (12) 2915-2934
  • 5 Iida K, Sudo A, Ishiguro S. Clinical and radiological results of calcium phosphate cement-assisted balloon osteoplasty for Colles' fractures in osteoporotic senile female patients. J Orthop Sci 2010; 15 (2) 204-209
  • 6 Hahnhaussen J, Hak DJ, Weckbach S, Heiney JP, Stahel PF. Percutaneous inflation osteoplasty for indirect reduction of depressed tibial plateau fractures. Orthopedics 2012; 35 (9) 768-772
  • 7 Sandmann GH, Ahrens P, Schaeffeler C , et al. Balloon osteoplasty—a new technique for minimally invasive reduction and stabilisation of Hill-Sachs lesions of the humeral head: a cadaver study. Int Orthop 2012; 36 (11) 2287-2291
  • 8 Mauffrey C, Bailey JR, Hak DJ, Hammerberg ME. Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable bone tamp: description of a novel and safe technique. Patient Saf Surg 2012; 6 (1) 6
  • 9 Heim KA, Sullivan C, Parekh SG. Cuboid reduction and fixation using a kyphoplasty balloon: a case report. Foot Ankle Int 2008; 29 (11) 1154-1157
  • 10 Gupta AK, Gluck GS, Parekh SG. Balloon reduction of displaced calcaneus fractures: surgical technique and case series. Foot Ankle Int 2011; 32 (2) 205-210
  • 11 König B, Khodadadyan C, Schäffler A, Pflugmacher R, Stöckle U. [Percutaneously navigated balloon fracture reduction in a displaced acetabular fracture]. Unfallchirurg 2007; 110 (12) 1072-1075
  • 12 Melkerson MN. 510(k) Number, K123771. In: Administration TFaD ed; 2012
  • 13 Heiney JP, O'Connor JA. Balloon reduction and minimally invasive fixation (BRAMIF) for extremity fractures with the application of fast-setting calcium phosphate. J Orthopaedics 2010; 7 (2) e8
  • 14 Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968–1975. Clin Orthop Relat Res 1979; (138) 94-104
  • 15 Ahrens P, Sandmann G, Bauer J , et al. Balloon osteoplasty—a new technique for reduction and stabilisation of impression fractures in the tibial plateau: a cadaver study and first clinical application. Int Orthop 2012; 36 (9) 1937-1940
  • 16 Gardner MJ, Yacoubian S, Geller D , et al. The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients. J Orthop Trauma 2005; 19 (2) 79-84
  • 17 Jordan R, Hao J, Fader R, Gibula D, Mauffrey C. Study protocol: trial of inflation osteoplasty in the management of tibial plateau fractures. Eur J Orthop Surg Traumatol 2013; ; June 26 (e-pub ahead of print)