Analysis of curative effect of different surgical approaches for posterior column fracture in tibial plateau

Objective To investigate the operative procedures of posterior column fracture in tibial plateau,analyze and compare the curative effect of different surgical approaches.Methods Twenty nine cases of posterior column fracture in tibial plateau were operated.There were 10 cases of posteromedial plus anterior approach(PMA),and 19 cases of anterior approach(AA).The fracture healing time,tibial plateau posterior slope angle and varus angulation,Rasmussen reset anatomy score,HSS function scores of knee were statistically analyzed,in order to find out interrelationship between the different path operation type and fracture healing,reduction effect,reduction stability and knee joint function.Results Fracture healing time in group PMA was less than in group AA.A comparison concerning tibial plateau posterior slope and varus angle was made immediately after operation with 12 months after operation in group PMA and group AA,the difference was of no significance(P 0.05).There was no significant difference in Rasmussen reset anatomical score immediately after operation and HSS knee function score 12 months after operation in two groups(P 0.05).Conclusion Anterior and posterior approach operation of posterior column fracture in tibial plateau can shorten the time of fracture healing.There are no differences among the reduction effect,the reduction stability and function recovery in knee joint in the two groups.The surgical approach should be chosen based on the size and position and direction and displacement of posterior tibial plateau fracture block.