Use of genex in the treatment of a tibial plateau fracture
Courtesy of Prof. Hemant K Sharma, Consultant Orthopaedic Surgeon, Hull, UK.
60-year-old female, with a prior history of left femur fracture treated with intramedullary nailing, and a left acetabular fracture managed with open reduction and internal fixation (ORIF). The patient sustained an injury whilst skiing, which resulted in a Schatzker 6 plateau fracture on her left side.
The patient was positioned supine, and a tourniquet was applied for hemostatic control. A minimal incision was made, and depressed articular segment was elevated using a punch. The elevated segment was stabilized with two wires, and 10 cc of genex was applied. A compression clamp was applied and partially threaded cannulated screws were inserted while the genex remained mouldable, ensuring optimal compression and stability. Following this, a circular hexapod frame was applied to facilitate fracture reduction, allowing for precise post-operative adjustment of bony alignment.
Post-operatively, the limb length discrepancy was addressed with 5 mm of distraction as the patient perceived the leg to be slightly short.
At 3 months, the fracture was healed and ready for reloading. The frame was removed 4 months post-surgery.
At the final follow-up at 1 year, the patient was independently mobile, pain-free, and had knee range of motion of 0–130˚.
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