• 1. Department of Orthopaedic Center No. 3 Joint Section, Affiliated Hospital of Logistics University of Chinese People's Armed Police Force, Tianjin, 300162, P. R. China;
  • 2. Outpatient Department of Chinese People's Armed Police Force Corps of Tianjin;
WANGWenliang, Email: 289765450@qq.com
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Objective To explore the effectiveness of posteromedial and anterolateral approaches in the treatment of posterolateral tibial plateau collapsed and splited fractures. Methods Nineteen consecutive patients with posterolateral tibial plateau collapsed and splited fractures were treated between August 2010 and August 2013, and the clinical data were retrospectively analyzed. There were 13 males and 6 females, with an average age of 36.9 years (range, 25-75 years). All cases had closed fractures, involving 8 left sides and 11 right sides. Fractures involved posterior column according to the threecolumn classification based on CT scans; according to the Schatzker classification, all fractures were type Ⅱ; according to the AO/Association for the Study of Internal Fixation classification (AO/OTA), all fractures were type 41-B3.1.2. The interval between injury and operation was 7-14 days (mean, 9 days). The reduction of collapsed fractures and implantation of artificial bone allograft were supported by T-shaped distal radius plate via the posteromedial approach. The splited fractures was fixed by less invasive stabilization system (LISS) plate via the anterolateral approach. Results The mean operation time was 69.0 minutes (range, 50-105 minutes). All incisions healed by first intention without neurovascular complications or wound infection. All patients were followed up 14-20 months (mean, 18.2 months). X-ray and CT examinations showed that collapsed tibial plateau and joint surface were completely corrected; bony union was obtained at 12 weeks on average (range, 10-16 weeks). No secondary collapsed fracture and knee varus or valgus occurred. The results were excellent in 12 cases, good in 5 cases, and fair in 2 cases with an excellent and good rate of 89.5% according to the Rasmussen's scoring system for knee function. Conclusion The posteromedial approach combined with anterolateral approach for posterolateral tibial plateau fractures can fully expose the posterolateral aspects of the tibial plateau, and thus collapsed and splited fractures can be treated at the same time, which will lead to less operative time and good outcomes in the treatment of posterolateral tibial plateau collapsed and splited fractures.

Citation: ZHANGPeng, LIChengliang, CHENFangjian, YANWenshan, WANGWenliang. TREATMENT OF POSTEROLATERAL TIBIAL PLATEAU COLLAPSED AND SPLITED FR ACTURES BY POSTEROMEDIAL AND ANTEROL ATER AL APPROACHES. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(9): 1072-1075. doi: 10.7507/1002-1892.20150232 Copy

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