Evaluation of popliteal artery injury risk with locked lateral plating of the tibial plateau

Michael Dee, John M. Sojka, Miguel S. Daccarett, Matthew A Mormino

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

OBJECTIVES:: This study was undertaken to determine if there is increased likelihood of popliteal artery injury as one places a fixed-angle lateral proximal tibia locking plate with posterior plate lift off and or anterior plate translation from the ideal position. METHODS:: A Synthes (Synthes USA, West Chester, PA) 3.5-mm and 4.5-mm lateral proximal tibia locking plate was placed consecutively on each of six specimens in the straight lateral (SL) position. Screw position with respect to the medial cortex was recorded as well as the distance of the posterior most screw tip to the popliteal artery. Next a 3-mm shim was placed under the posterior edge of the same plate to mimic posterior plate lift off (LO) followed by placement of a 6-mm shim. The same experiment was repeated with the plate translated 5 mm anteriorly (AT). RESULTS:: The popliteal artery was injured in zero of six specimens using the 3.5-mm plate. The popliteal artery was injured in six of six specimens using the 4.5-mm plate in the 5-mm AT 6-mm LO position, five of six with 5-mm AT and 3-mm LO, two of six with only 5-mm AT, four of six with SL and 6-mm LO, two of six with SL and 3-mm LO, and zero of six with SL. CONCLUSION:: The Synthes 4.5-mm plate can put the popliteal artery at risk with as little as 3-mm posterior liftoff in the intended straight lateral position or with 5-mm anterior plate translation with no posterior liftoff. Therefore, placement of the 4.5-mm plate in the proper position and confirmation of its position with a true lateral radiograph is paramount to avoid injury to the popliteal artery.

Original languageEnglish (US)
Pages (from-to)603-607
Number of pages5
JournalJournal of Orthopaedic Trauma
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2011

Fingerprint

Popliteal Artery
Wounds and Injuries
Tibia

Keywords

  • fixedangle device
  • malposition
  • popliteal artery injury
  • tibial plateau fractures

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Evaluation of popliteal artery injury risk with locked lateral plating of the tibial plateau. / Dee, Michael; Sojka, John M.; Daccarett, Miguel S.; Mormino, Matthew A.

In: Journal of Orthopaedic Trauma, Vol. 25, No. 10, 01.10.2011, p. 603-607.

Research output: Contribution to journalArticle

Dee, Michael ; Sojka, John M. ; Daccarett, Miguel S. ; Mormino, Matthew A. / Evaluation of popliteal artery injury risk with locked lateral plating of the tibial plateau. In: Journal of Orthopaedic Trauma. 2011 ; Vol. 25, No. 10. pp. 603-607.
@article{89019a89f6474228a52fdb7a3db589bc,
title = "Evaluation of popliteal artery injury risk with locked lateral plating of the tibial plateau",
abstract = "OBJECTIVES:: This study was undertaken to determine if there is increased likelihood of popliteal artery injury as one places a fixed-angle lateral proximal tibia locking plate with posterior plate lift off and or anterior plate translation from the ideal position. METHODS:: A Synthes (Synthes USA, West Chester, PA) 3.5-mm and 4.5-mm lateral proximal tibia locking plate was placed consecutively on each of six specimens in the straight lateral (SL) position. Screw position with respect to the medial cortex was recorded as well as the distance of the posterior most screw tip to the popliteal artery. Next a 3-mm shim was placed under the posterior edge of the same plate to mimic posterior plate lift off (LO) followed by placement of a 6-mm shim. The same experiment was repeated with the plate translated 5 mm anteriorly (AT). RESULTS:: The popliteal artery was injured in zero of six specimens using the 3.5-mm plate. The popliteal artery was injured in six of six specimens using the 4.5-mm plate in the 5-mm AT 6-mm LO position, five of six with 5-mm AT and 3-mm LO, two of six with only 5-mm AT, four of six with SL and 6-mm LO, two of six with SL and 3-mm LO, and zero of six with SL. CONCLUSION:: The Synthes 4.5-mm plate can put the popliteal artery at risk with as little as 3-mm posterior liftoff in the intended straight lateral position or with 5-mm anterior plate translation with no posterior liftoff. Therefore, placement of the 4.5-mm plate in the proper position and confirmation of its position with a true lateral radiograph is paramount to avoid injury to the popliteal artery.",
keywords = "fixedangle device, malposition, popliteal artery injury, tibial plateau fractures",
author = "Michael Dee and Sojka, {John M.} and Daccarett, {Miguel S.} and Mormino, {Matthew A}",
year = "2011",
month = "10",
day = "1",
doi = "10.1097/BOT.0b013e318206fa99",
language = "English (US)",
volume = "25",
pages = "603--607",
journal = "Journal of Orthopaedic Trauma",
issn = "0890-5339",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Evaluation of popliteal artery injury risk with locked lateral plating of the tibial plateau

AU - Dee, Michael

AU - Sojka, John M.

AU - Daccarett, Miguel S.

AU - Mormino, Matthew A

PY - 2011/10/1

Y1 - 2011/10/1

N2 - OBJECTIVES:: This study was undertaken to determine if there is increased likelihood of popliteal artery injury as one places a fixed-angle lateral proximal tibia locking plate with posterior plate lift off and or anterior plate translation from the ideal position. METHODS:: A Synthes (Synthes USA, West Chester, PA) 3.5-mm and 4.5-mm lateral proximal tibia locking plate was placed consecutively on each of six specimens in the straight lateral (SL) position. Screw position with respect to the medial cortex was recorded as well as the distance of the posterior most screw tip to the popliteal artery. Next a 3-mm shim was placed under the posterior edge of the same plate to mimic posterior plate lift off (LO) followed by placement of a 6-mm shim. The same experiment was repeated with the plate translated 5 mm anteriorly (AT). RESULTS:: The popliteal artery was injured in zero of six specimens using the 3.5-mm plate. The popliteal artery was injured in six of six specimens using the 4.5-mm plate in the 5-mm AT 6-mm LO position, five of six with 5-mm AT and 3-mm LO, two of six with only 5-mm AT, four of six with SL and 6-mm LO, two of six with SL and 3-mm LO, and zero of six with SL. CONCLUSION:: The Synthes 4.5-mm plate can put the popliteal artery at risk with as little as 3-mm posterior liftoff in the intended straight lateral position or with 5-mm anterior plate translation with no posterior liftoff. Therefore, placement of the 4.5-mm plate in the proper position and confirmation of its position with a true lateral radiograph is paramount to avoid injury to the popliteal artery.

AB - OBJECTIVES:: This study was undertaken to determine if there is increased likelihood of popliteal artery injury as one places a fixed-angle lateral proximal tibia locking plate with posterior plate lift off and or anterior plate translation from the ideal position. METHODS:: A Synthes (Synthes USA, West Chester, PA) 3.5-mm and 4.5-mm lateral proximal tibia locking plate was placed consecutively on each of six specimens in the straight lateral (SL) position. Screw position with respect to the medial cortex was recorded as well as the distance of the posterior most screw tip to the popliteal artery. Next a 3-mm shim was placed under the posterior edge of the same plate to mimic posterior plate lift off (LO) followed by placement of a 6-mm shim. The same experiment was repeated with the plate translated 5 mm anteriorly (AT). RESULTS:: The popliteal artery was injured in zero of six specimens using the 3.5-mm plate. The popliteal artery was injured in six of six specimens using the 4.5-mm plate in the 5-mm AT 6-mm LO position, five of six with 5-mm AT and 3-mm LO, two of six with only 5-mm AT, four of six with SL and 6-mm LO, two of six with SL and 3-mm LO, and zero of six with SL. CONCLUSION:: The Synthes 4.5-mm plate can put the popliteal artery at risk with as little as 3-mm posterior liftoff in the intended straight lateral position or with 5-mm anterior plate translation with no posterior liftoff. Therefore, placement of the 4.5-mm plate in the proper position and confirmation of its position with a true lateral radiograph is paramount to avoid injury to the popliteal artery.

KW - fixedangle device

KW - malposition

KW - popliteal artery injury

KW - tibial plateau fractures

UR - http://www.scopus.com/inward/record.url?scp=80052872604&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052872604&partnerID=8YFLogxK

U2 - 10.1097/BOT.0b013e318206fa99

DO - 10.1097/BOT.0b013e318206fa99

M3 - Article

VL - 25

SP - 603

EP - 607

JO - Journal of Orthopaedic Trauma

JF - Journal of Orthopaedic Trauma

SN - 0890-5339

IS - 10

ER -