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The extended posterolateral approach for split depression lateral tibial plateau fractures extending into the posterior column: 2 years follow up results of a prospective study |
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| Institution: | 1. Parvathy Hospital, Chennai, India;2. MOSC Medical College Hospital, Cochin, India;3. Swaram Hospital, Chennai, India;4. Mehta Hospital, Chennai, India;1. KU Leuven – University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium;2. University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium;3. University Hospitals Leuven, Care Program Management, B-3000 Leuven, Belgium;4. KU Leuven – University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium;1. Department of Respiratory and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, PR China;2. Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China;1. Ilizarov Unit S.C Ortopedia e Traumatologia, Manzoni Hospital, Lecco, Italy;2. Department of Orthopedic and Trauma, Postgraduate Medical Institute Hayatabad, Medical Complex, Peshawar, Pakistan;1. The Orthopaedic Trauma Unit, Division of Orthopaedics, University of Alabama at Birmingham, United States;2. Talpiot Medical Leadership Program, Sheba Medical Centre, Israel;1. North of Scotland Specialty Training Programme, United Kingdom;2. Division of Applied Medicine, University of Aberdeen, United Kingdom;3. Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom;4. Institute of Cellular Medicine, Newcastle University, United Kingdom |
| Abstract: | ObjectiveTo prospectively study the outcome of surgically treated split depression lateral tibial plateau fractures extending into the posterior column using the extended posterolateral approach.MethodsTwenty-one patients with split depression lateral tibial plateau fractures (AO: 41-B3) with extension into the posterior column were treated with open reduction and internal fixation through an extended posterolateral approach with osteotomy of the fibular neck ± Gerdy tubercle. Follow up radiographs was assessed for quality of articular reduction and limb axis. Functional assessment was performed at last follow up using the Tegner–Lysholm score. Complications pertaining to the surgical approach were recorded.ResultsThe approach was performed in 15 patients with a fibular neck osteotomy alone and 6 patients required a Gerdy's tubercle osteotomy also. All fractures and osteotomies had united. Anatomical articular reduction was achieved in 16 patients. Radiological limb alignment was restored in all patients except for a reversed posterior slope in 1 patient. Arthritic changes were seen in 3 patients. The mean Tegner–Lysholm score was 87.3 (range: 76–95) at last follow up. No specific complications related to the surgical approach like common peroneal nerve injury and lateral instability of the knee was encountered.ConclusionThe extended posterolateral approach offers excellent exposure posterior to the fibular head to perform articular reduction and fixation achieving satisfactory radiological and functional results in split depression lateral tibial plateau fractures extending into the posterior column. |
| Keywords: | Lateral tibial plateau fractures AO: 41-B3 fractures Posterior column Posterolateral rim fractures |
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