Posteromedial tibial plateau fractures – Functional outcome of posteromedial buttress plating with precontoured locking plate using modified lobenhoffer approach

Abstract

Posterior tibial plateau fractures have a complex intra-articular fracture pattern, representing approximately 1.2% of all fractures. The occurrence of the posteromedial shear fragment is relatively common in high-energy tibial plateau fractures. Aims and Objectives: To study the role of posteromedial plating in the management of complex tibial plateau fractures with a posteromedial fragment. Materials and Methods: Only patients with posteromedial fracture patterns alone are taken into account. Twenty cases above 20 years of age, from the patient, admitted to Government Medical College, Thrissur, with posteromedial fragment in tibial plateau fractures that were operated were undertaken for the study. The patients were followed up for 2 years. Results: Of the 20 patients with posteromedial tibial plateau fractures from X-ray and computed tomography scan of the knee joint, all patients were treated with precontoured posteromedial buttress plating using single anatomical locking plate. We analyzed patients with Rasmussen scoring postoperatively. In our analysis, among 20 patients, the functional score was excellent in 14, good in 5, fair in 1, and poor in none. There was one patient with compartment syndrome who had developed a mild surgical site infection that later resolved. No excessive collapse is seen postoperatively since locked plate is used. Four patients had transient paraesthesia of the saphenous nerve; both resolved completely.