Abstract
Modified and Combined Lateral and Posterolateral Approach an Alternative Treatment to Tibial Plateau Fractures
Highlights
Articular stepoffs and angular deformities after operative treatment of tibial plateau fractures are observed in 19% to 26% of cases [1,2]
The approach involves a lateral arthrotomy for visualizing the joint surface and a posterolateral approach for the fracture reduction and plate fixation, which are both achieved through one posterolateral skin incision
There is evidence in the literature that the quality of the reduction correlates with the clinical outcome [3,4]. This correlation is further supported by the fact that painful intra-articular malunions of the tibial plateau require complicated operations such as combined extra- and intra-articular osteotomies to improve their outcome [5,6]. These results indicate that an anatomic fracture reduction without intra-articular stepoffs is an important goal in the treatment of tibial plateau fractures [2,4,6]
Summary
Articular stepoffs and angular deformities after operative treatment of tibial plateau fractures are observed in 19% to 26% of cases [1,2]. Isolated posterior approaches allow for fragment fixation [1,9], but the visual control of fracture reduction is limited, especially if the fractures are more complex In this case report, a modified surgical technique for the treatment of posterolateral tibia plateau fractures is introduced. This technique includes a posterolateral approach for fracture reduction and fixation combined with a lateral arthrotomy to visually control the fracture alignment and the joint surface. Lateral arthrotomy (edge of meniscus stay suture tied) allows accurate articular reduction
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