Abstract
BackgroundIn tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat. Although there are many surgical approaches and fixation methods for the treatment of these fractures, all of these methods have limitations. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. This study details the technique of treating these fractures with the RSP and special pressurizer and provides the outcomes.MethodsFrom May 2016 to January 2019, the data of 12 patients with posterolateral tibial plateau fractures treated with the RSP and special pressurizer in our hospital were retrospectively analyzed. Postoperative rehabilitation was advised, knee X-rays were taken at follow-ups, and fracture healing, complications, and knee range of motion were assessed. The Hospital for Special Surgery (HSS) knee score and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to evaluate knee function at the last follow-up.ResultsThe average follow-up time of all patients was 16.5 months (range, 12–25 months). The average bony union time was 3.2 months (range, 3–4.5 months). At the last follow-up, the average knee range of motion was 138° (range, 107–145°). The average HSS score was 91 (range, 64–98). The average KOOS Symptoms score was 90 (range, 75–96). The average KOOS Pain score was 91 (range, 72–97). The average KOOS ADL score was 91 (range, 74–97). The average KOOS sport/recreation score was 83 (range, 70–90). The average KOOS QOL score was 88 (range, 69–93). Skin necrosis, incision infections, and fixation failure did not occur during the follow-up period.ConclusionsWith our newly designed RSP and special pressurizer, posterolateral tibial plateau fractures can be easily and effectively reduced and fixed through the anterolateral approach, which serves as a novel treatment for posterolateral tibial plateau fractures.
Highlights
In tibial plateau fractures, the posterolateral segment of the tibia plateau is frequently affected and challenging to treat
There are many surgical approaches and internal fixation methods for this type of fracture, methods that have the advantages of simple surgical approaches lead to small intraoperative trauma and have reliable internal fixation effects have not been reported
Approach Under general anesthesia or spinal anesthesia, the patient was placed in the supine position, the affected limb was bent at the hip and knee by approximately 30–40°, and the calf was placed in neutral rotation
Summary
The posterolateral segment of the tibia plateau is frequently affected and challenging to treat. We designed a new rotational support plate (RSP) and a special pressurizer that can fix the fracture directly via the anterolateral approach. This method is advantageous because it leads to little trauma, involves a simple operation, and has a reliable fixation effect. The posterolateral segment of the tibia plateau is frequently affected and challenging to treat [1]. Fibula osteotomy provides more exposure of the posterolateral plateau, fracture healing at the osteotomy site and the stability of the lateral structure of the knee joint are not ideal [6]. There are many surgical approaches and internal fixation methods for this type of fracture, methods that have the advantages of simple surgical approaches lead to small intraoperative trauma and have reliable internal fixation effects have not been reported
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