Treatment of simple posterior and posterolateral fractures of the lateral tibial plateau via a posterolateral approach

Objective To discuss treatment of uncommon simple posterior and posterolateral fractures of the lateral tibial plateau via a self-designed posterolateral approach. Methods From May 2007 to October 2007,6 patients with simple posterior and posterolateral fractures of the lateral tibial plateau were treated via a self-designed posterolateral approach.They were 4 males and 2 females,with a mean age of 49.8 years (range,36 to 57).According to the AO classification system,2 of them were posterolateral tibial plateau depression (41-B-2.2.4);the other 4 were posterolateral tibial plateau split depression (41-B-3.1.2).In 4 eases we usedTtype buttress plates,while the L type buttress plates were used in the other 2 cases. Results X-ray examinations showed that all the cases obtained anatomic reduction.The patients were followed up for 15 to 37 weeks,with a mean period of 26.3 weeks.The fractures were all healed and no height loss was found.The mean Rasmussen score was 17.3 points(range,16 to 18).At the latest follow-up,the average ROM of the affected knee joints was 120°(range,100°to 135°),and the mean HSS(The Hospital For Special Surgery) score was 89.3 points(range,85 to 95). Conclusions Simple posterior and posterolateral fractures of the lateral tibial plateau usually result from direct axial compression,with the knee joint at a valgus moment.The posterolateral approach is ideal for these fractures,because of good exposure,convenient placement of the buttress plate,limited invasion and the excellent clinical results. Key words: Tibia; Fracture; Approach; Plate; Fracture fixation,internal