In September 2013 I had a motorcycle accident and had a multi-fragmental tibial plateau fracture, which was plated and screwed to fix the break, but it left me with a bad slope to my tibia. My leg was unusable really - I couldn’t walk on it, it was complete agony..........When I last saw Mr Wilson for a check up I got quite emotional, which I have done a few times with him, but, you know, I said to him "You really have given me my life back and I really appreciate that."
Regarding the video above, these two images are both the same lateral view of her injured leg before this osteotomy procedure. You can see the fixation from the original operation, but look above it at the tibial plateau. You can see that it is at a very bad angle (or 'slope'). On the right version we have marked this for you - the plateau is sloping down to the front at an angle of 102 degrees, which is far too much.
In order to correct the slope, the old fracture fixation was removed. A section of tibia with patellar tendon still attached was lifted up, and a wide gap wedged opened at the front of the tibia.
A bone wedge was then inserted into the gap. The size of the opening and the bone wedge had been carefully calculated with our digital planning software.
After the wedge was positioned into the gap, the section of tibia that had been lifted up was not replaced and fixed in place - acting as a biological bone bridge fixation. We got the slope to positive 5 degrees so 85 from 102°.
Here we present the stories of two young people who suffered tibial plateau injuries resulting in a negative slope on their tibial plateau. In both cases the situation was very disabling, and we turned their lives around with osteotomy and 'biological plating'.
By 'biological plating' we mean using the sliver of bone from the front of the tibia, which needs to be lifted together with the patellar tendon to give the surgeon access to the front part of the tibia where it needs to be cut and wedged. The sliver, when brought back to its original position, then unites across the gap as the bone grows back together.
The video testimonial on the left supports the excellent outcome in a young woman, previous very active, whose life was set right back after an accident which left her with a bad slope to the tibial plateau where she had had a fracture reduced and plated, and which had healed in a bad position.
The smaller video below shows a slope-changing and biological plating procedure in a young man - but both patients essentially had the same operation.
This video shows the surgical procedure in the young man, but the principle is just the same in the two cases.
On the left of the photo at the front of the video you can see the assistant holding the sliver over bone away to the side so that the surgeon can get access for the osteotomy.
You can also see the gap that has been cut into the tibia at the front. So the gap is then filled with a bone wedge, and the sliver of lifted bone is replaced and fixed back into position to act as the 'biological plate' across the osteotomy area.
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