Surgical treatment of tibial plateau fractures involved the posterior condylar

Objective To investigate surgical outcome of tibial plateau fracture involved the posterior condylar which was guided by three columns theory of tibial plateau fracture. Methods Seventeen patients with tibial plateau fractures involved the posterior condylar treated in the Third Affiliated Hospital of Anhui Medical University from June 2011 to May 2013 were analyzed retrospectively, in which male 12 patients, female 5 patients, age 20-54 years old, average 33.8 years old; Schatzker fracture classification: Ⅰtype 2 patients, Ⅲ type 3 patients, Ⅳ type 3 patients, Ⅴ type 7 patients, Ⅵ type 2 patients, three columns fracture classification: Simple posterior column fracture 4 patients, posterior column fracture combined lateral column 4 cases, posterior column fracture combined medial column 2 patients, posterior column fracture combined lateral column and medial column fracture 7 patients. TheLincision behind the knee joint was used for simple posterior column fracture or combined medial column fracture of tibial plateau, while theLincision and anterolateral incision of the knee joint were used for posterior column fracture combined lateral column or combined lateral and medial column fracture of tibial plateau. Knee X-ray was examined and the varus angle and posterior slope of tibial plateau were measured postoperatively, while knee Rasmussen function score was assessed postoperatively. Results Seventeen patients were received more than 1 year follow-up, all tibial plateau fractures were healed, in which there were no complication of infection, skin necrosis, loosening and breakage of internal fixation. The mean varus angle of tibial plateau in patients was 86.27°±0.35° postoperatively, and it was 86.39°±0.32° at 1 year after operation(t=0.940). The mean posterior slope of tibial plateau was 9.15°±0.34° postoperatively, and it was 9.17°±0.34° at 1 year after operation(t=0.687). There were no significant differences in the varus angle and posterior slope of tibial plateau between 1 year after operation and immediate postoperative(all P values >0.05). The total fine rate of 17 patients in knee Rasmussen function score was 16/17 at 1 year after operation. Conclusions Three column theory of tibial plateau fracture is a fine guidance in the surgical treatment to tibial plateau fractures involved the posterior condylar, theLincision behind the knee joint or combined the auxiliary anterolateral incisions of the knee joint have the good exposure and corresponding fixation to the most tibia platfeau fracture involved the posterior condylar. Key words: Tibial fractures; Fracture fixation; Posterior condylar injuries; Three columns classification