Treatment of lateral and posterior column fractures of the tibial plateau via the combined anterolateral and posteromedial approaches

LIAN Ji-wen; WANG Hong-jiang; YANG Zhan-feng; CUI Hong-gang; WANG Quan; GAO Ming-tang

doi:10.3969/j.issn.1009-4237.2016.11.011

Abstract：Objective To explore the effectiveness of combined posteromedial and anterolateral approaches for the treatment of lateral and posterior column tibial plateau fractures.Methods The clinical data of 19 patients [12 males and 7 females aged from 21-72(average 38.1) years] with posterior lateral and posterior tibial plateau fractures treated in our hospital from Apr.2012 to Feb.2015 were retrospectively analyzed.All patients were ex-posed to fracture,reduction,bone graft and plate fixation,and repair of the combined meniscus and ligament injury. Ten were on the left and 9 were on the right.The quality of the fracture reduction was evaluated by comparing PT and PS angle(healthy side and postoperative immediately).The healing of fracture and internal fixation stability were evaluated by comparing PT and PS angle( postoperative immediately and 12 months after surgery ) .HSS scores was used to evaluate the knee joint function.Results All of the 19 patients were followed up for 12-26 months,av-eraging 14.6 months.The clinical healing time of fracture was 9-15 weeks,with an average of 14.2 weeks.No sta-tistical difference was found in the comparison of PT and PS angle in the healthy side before the operation,immedi-ately after the operation and 12 months after surgery.HSS scores of all the patients were excellent and the mean score was 86.7(from 82 to 94).Conclusion The posterior medial and lateral approaches for the treatment of lat-eral tibial plateau fractures and posterior column fractures are effective,which is conductive to fracture reduction,fix-ation and postoperative knee function recovery.