Retrospective Study of 23 Patients with Traumatic Posterolateral Tibial Plateau Fracture Treated in a Single Center Between 2017 and 2019 with Lateral Arthrotomy, Reduction, and Plate Fixation Using the Frosch Approach.

Abstract

BackgroundThe Frosch approach is a posterolateral surgical procedure performed with or without osteotomy of the fibula for the treatment of posterolateral tibial plateau fractures (PLFs). This retrospective study from a single center aimed to evaluate 23 patients with PLFs who underwent surgical reduction with the Frosch approach between January 2017 and October 2019.Material/MethodsTwenty-three patients, 4 with Schatzker type V and 19 with Schatzker type II fractures were enrolled. Postoperative radiographs were performed regularly to measure the medial proximal tibial angle (MTPA), lateral posterior slope angle (LPSA), medial posterior slope angle (MPSA), and articular step-off to evaluate the fracture reduction. At the last follow-up, the Hospital for Special Surgery (HSS) knee score and knee range of motion (ROM) were used to assess knee function.ResultRadiograph examinations indicated excellent reduction and fixation of fractures in all patients. The average HSS scores and ROM of the 23 patients were 88.0±3.5 and 131.8±7.8°, respectively, with an average of 30.5±4.6 months of follow-up. Skin numbness occurred in 3 patients but was recovered within 6 months. One patient sustained superficial wound infection, and another patient had superficial adipose tissue liquefaction necrosis.ConclusionsThis experience from a single center demonstrated the advantage of the Frosch approach in visualizing the posterolateral and lateral tibial plateau from a single surgical incision and resulted in excellent postoperative outcomes at follow-up when evaluated by the HSS score, ROM, and radiographic evaluation of the MTPA, LPSA, and MPSA.