Abstract
BackgroundOur hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. We compared the clinical effects of this method in Schatzker type II or type V/VI fractures with posterolateral tibial plateau fracture based on our patients.MethodsThe patients from January 2013 to December 2015 were summarized, and some of them were assisted with arthroscopy. According to Schatzker classification, patients with Schatzker type II fracture were divided into group A; patients with Schatzker type V/VI fracture were divided into group B. The fracture characteristics, operation statistics, and postoperative functional evaluation of each group were compared.ResultsA total of 46 patients were included in the study and were followed up for 23–45 months. There were 24 cases in group A and 22 cases in group B. The operation time and the amount of bleeding were significantly less in group A (P < 0.05). Twelve cases were assisted with arthroscopy including 6 patients in each group. The fracture healing time made no significant difference in the two groups (P > 0.05). All patients experienced no significant influence on daily life. The knee Rasmussen score was 26.8 in group A and 23.5 in group B (P > 0.05), and the knee range motion was 115.5° in group A and 106.6° in group B (P > 0.05). The excellent and good rate of reduction was 91.7% in group A and 81.8% in group B (P > 0.05), but the excellent rate of reduction was 83.3% in group A and 27.3% in group B (P < 0.05). The unfixed rate of posterolateral fracture was 16.7% in group A and 36.4% in group B (P > 0.05). One patient in group B suffered postoperative wound infection.ConclusionsThe extended anterolateral approach could obtain similar satisfactory clinical results in simple/complex tibial plateau fracture with posterolateral tibial plateau fracture. It seemed that easier operation, better posterolateral fracture reduction, and fixation occurred in relative simple fracture from our cases.Trial registrationIt was a retrospective study. This study was consistent with the ethical standards of the Second Affiliated Hospital of Zhejiang University Medical College and was approved by the hospital ethics committee and the trial registration number of our hospital was 20170053.
Highlights
Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture
We summarized the experience and compared the clinical results in these two groups to confirm the differences in simple/complex tibial plateau fracture with posterolateral tibial plateau fracture by this method
According to Schatzker classification, 24 patients of Schatzker type II fracture were divided into group A, and 18 patients of type V fracture and 4 patients of type VI fracture were divided into group B
Summary
Our hospital has recently used the extended anterolateral approach in posterolateral tibial plateau fracture. A posterolateral fracture fragment in tibial plateau was defined as any separate posterolateral quadrant-based articular fracture fragment, with the extension of the fracture line to the posterolateral cortex [1]. This type of fracture was not as uncommon as previously believed. Luo et al used an inverted L-shaped incision [2, 6]; Chang et al used a single posterolateral approach to expose and reduce the fracture directly [7, 8]; Lobenhoffer et al firstly used the fibular osteotomy approach in the treatment of posterolateral fracture [9, 10] These shortcomings such as complex operation technique, possibility of damage to important blood vessels and nerves, and trouble with changing the body position existed in these approaches. The extended anterolateral approach was developed for posterolateral tibial plateau fracture [11, 12]
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