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Vanessa Morello Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland

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Axel Gamulin Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, Geneva, Switzerland

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occurrence in tibial plateau fractures reaches 12% and even 53% in higher-energy patterns ( 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ). In tibial shaft fractures, ACS occurrence reaches 11.5% ( 10

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Ippokratis Pountos Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, UK

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Peter V. Giannoudis Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, and NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, LS7 4SA Leeds, West Yorkshire, Leeds, UK

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might be impractical for the vast majority of intra-articular impacted fractures with the nature of peri-articular soft tissues often sustained. In the knee joint, common injuries include meniscal lesions in tibial plateau fractures which have been

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Josep Muñoz Vives Hospital Nostra Senyora de Meritxell, Andorra, Spain

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Jean-Christophe Bel Hospices Civils de Lyon, Lyon, France

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Arantxa Capel Agundez Hospital Universitario 12 de Octubre, Madrid, Spain

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Francisco Chana Rodríguez Hospital General Universitario Gregorio Marañón, Madrid, Spain

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José Palomo Traver Hospital General de Castelló, Castelló de la Plana, Spain

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Morten Schultz-Larsen Odense Universitetshospita, Odense, Denmark

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Theodoros Tosounidis Leeds General Infirmary, Leeds, UK

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tibial shaft fracture and type II c) (9%) is a fracture of the tibia plateau and articular fracture of the distal femur. 2 Fig. 1 Fraser classification of the floating knee. Initial management The floating knee is much more than a

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Thomas Tampere Department of Orthopaedic Surgery, Ghent University Hospital, Ghent, Belgium

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Matthieu Ollivier Institute for Locomotion, Aix-Marseille University, St. Marguerite Hospital, Marseille, France

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Christophe Jacquet Institute for Locomotion, Aix-Marseille University, St. Marguerite Hospital, Marseille, France

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Maxime Fabre-Aubrespy Institute for Locomotion, Aix-Marseille University, St. Marguerite Hospital, Marseille, France

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Sébastien Parratte Institute for Locomotion, Aix-Marseille University, St. Marguerite Hospital, Marseille, France
Department of Orthopaedic Surgery, International Knee and Joint Centre, Abu Dhabi, UAE

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the first choice in the treatment of complex tibial plateau or distal femoral fractures in elderly osteoporotic patients where articular and metaphyseal destruction makes reconstruction and internal fixation hazardous (Femur: AO/33C3 and selected 33C2

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Luke Turley Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Ian Barry Department of Plastic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia

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Eoin Sheehan Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Introduction Fractures of the tibial shaft represent 2% of all fractures and 37% of all long bone fractures in adults, at an incidence of 17–21 per 100,000 population ( 1 , 2 ). Due to the limited soft tissue coverage specific to the tibial

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Luca Dei Giudici Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, School of Medicine, Università Politecnica delle Marche, Ancona, Italy

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Andrea Faini Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, School of Medicine, Università Politecnica delle Marche, Ancona, Italy

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Luca Garro II Orthopaedic Division, Istituto Chirurgico Ortopedico Traumatologico, ICOT, Latina, Italy

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Agostino Tucciarone II Orthopaedic Division, Istituto Chirurgico Ortopedico Traumatologico, ICOT, Latina, Italy

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Antonio Gigante Clinical Orthopaedics, Department of Clinical and Molecular Science DISCLIMO, School of Medicine, Università Politecnica delle Marche, Ancona, Italy

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tibial plafond fractures. Variables contributing to poor results and complications . Clin Orthop Relat Res 1993 ; 292 : 108 - 17 . 2 Walsh EF , Akelman E , Fleming BC , DaSilva MF . Thumb carpometacarpal

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Carlos A. Encinas-Ullán Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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José M. Martínez-Diez Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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should be inserted under fluoroscopic guidance, if available. An alternative to using the C-clamp is to place the pins on the greater trochanter. Tibia Most tibial fractures can be stabilized with a unilateral frame in one plane ( Figs 5 and 6

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Cora Rebecca Schindler Department of Trauma-, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany

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Ramona Sturm Department of Trauma-, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany

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Jason Alexander Hörauf Department of Trauma-, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany

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Ingo Marzi Department of Trauma-, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany

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Philipp Störmann Department of Trauma-, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany

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fractures and tibial plateau fractures can be stabilized – tibial shaft fractures should be stabilized primarily. In this context, it should be emphasized that the individual biological conditions (e.g. age), the overall injury severity, but also severe of

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