An anterolateral approach for the flexion-valgus type unicondylar tibial plateau depression fracture pattern a technical note

Abstract

ObjectiveThe approach to pure depression fractures (PDF) of the posterolateral tibial plateau (PTP) is classically a posterior approach via a metaphyseal osteotomy window with elevation of the depressed articular fragment. Other posterolateral approaches have been described but have been criticized for affecting reduction quality, and risks to the common peroneal nerve. MethodsIn this case series, we describe a standard anterolateral approach with a window osteotomy through the metaphysis. Elevation of the PTP fracture is done through the osteotomy site. ResultsThe standard anterolateral approach avoids limitations of posterior or posterolateral approaches. Adequate reduction and good fixation of PDF of the PTP is attained. ConclusionThe anterolateral approach with osteotomy of the lateral condyle is reproducible and familiar. This avoids the need for a fibula osteotomy and the risks of neurovascular injury, while allowing adequate visualisation and fracture reduction. Level of evidenceIV.