Response to “Comment on: The ‘Hoop’ Plate for Posterior Bicondylar Shear Tibial Plateau Fractures: Description of a New Surgical Technique”
27 January 2017
09 March 2017
02 May 2017 (eFirst)
We appreciate your constructive comments about our article regarding our technique of using a “hoop” plate for posterior tibial plateau shear fractures.
In your letter, you suggest that the surgical technique might differ depending on the fracture pattern observed on the posterior aspect of the tibial plateau. In your opinion, no compression should be applied in cases where there is comminution of the posterior rim.
We agree with you with the following clarification. We support the concept that compression should not be applied in cases where the anteromedial and anterolateral columns of the proximal tibia are not continuous with the tibia shaft. This would cause an anterior displacement of the posterior rim.
Nevertheless, the “hoop plate” technique aims to restore the containment of the tibial plateau. The clamp is applied anteriorly to apply tension to the posterior rim, if we slightly pull the plate anteriorly. Because the hoop plate acts as a belt contouring the entire rim of the tibial plateau, it will likely not promote any further crush, provided the anterior rim is stable, and that the plate is buttressing the posterior rim.
We hope that this letter clarifies the technique described in our article, and we take this opportunity to thank you for taking your time to send us your relevant comment.
- 1 Giordano V, Schatzker J, Kfuri M. The “hoop” plate for posterior bicondylar shear tibial plateau fractures: description of a new surgical technique. J Knee Surg 2016; 30 (06) 509-513