OP Methods

In most cases it is necessary to surgically treat a tibial head fracture in order to restore a smooth joint surface in the long term and allow for undisturbed movement. In the case of smaller fractures, however, it may be sufficient to perform the procedure arthroscopically. In this case, the joint surface is merely raised slightly and thus smoothed.

In addition, the joint can be relined with the patient’s own bone tissue. In most cases, however, open surgery is necessary. The leg is brought back to its normal axis under traction.

This traction is then maintained, either with the aid of a fixator or with plates, screws and wires, until the fracture can heal in the correct position. All bone fragments that may have been created by the accident are reattached. In all operations it is particularly important that not only the leg axis is restored, but also that the joint surface is as smooth as possible.

This is especially important to prevent the development of osteoarthritis in the operated knee. Of course, any existing injuries to the ligaments or tendons of the knee are also treated during the operation. Damage to blood vessels or nerves can be partially treated.

Even after the operation, the leg is then fitted with a splint and thus immobilized. Here too, physiotherapy helps to prevent excessive muscle breakdown and to ensure the mobility of the joint at an early stage. For this purpose, the leg is mainly moved passively immediately after the operation.

In the further course of the operation, the focus is then on active training and strengthening of the musculature. Sufficient intake of painkillers is of course also part of the surgical aftercare. Especially if you try to be particularly brave after the operation, chronic pain can quickly develop. For this reason, pain should always be treated with a quick and sufficient analgesic medication.

Metal Removal

Whether it is necessary to remove the material introduced during the operation depends, apart from the surgical procedure, on how old you are and whether you have any complaints with the implanted material. Since any plates and screws are foreign bodies, there can always be irritation and reactions of the body to the material. Many patients find the materials unpleasant.

In some cases, the plates etc. may also be an obstacle to further healing at some point, for example, because they hurt under stress. In these cases, of course, metal removal is always sensible.

Otherwise, it can generally be said that in younger people it is more advisable to remove the foreign material. After all, otherwise you will carry it around with you for quite a while and the risk of later complications increases. It is also possible that the foreign material delays or prevents the formation of new bone material and thus stands in the way of further healing.

As an older person, it may be legitimate to leave plates or screws in place. Especially if they do not cause any discomfort, this can save the surgical risk during removal. If plates or screws remain after the operation and have to be removed later, this removal is usually necessary after about one year.

The procedure itself is then usually very short. Since metal removal causes much less tissue damage than the original surgery, recovery is much faster.In most cases, the load must first be increased here as well. However, a full load is usually possible again after only a few days.