Combined lateral peripatellar and posteromedial approaches for Schatzker type IV tibial plateau fractures involving posteromedial plane: a prospective study

Abstract

Background: The objective of this study to evaluate prospectively the effectiveness of Schatzker type IV tibial plateau fractures involving posteromedial plane managed by combined lateral peripatellar and posteromedial approaches. Methods: We analyzed 18 patients with Schatzker type IV tibial plateau fractures involving posteromedial plane. There were 12 males and 6 females with an average of 38.5 years (range, 25-60 years). The mechanism of injury included traffic accident in 15 patients and falling in 3 patients. The injured lower limbs were right in 11 patients and left in 7 patients. The mean time from injury to surgery was 6.78 days (range, 5-9 days). There were 8 patients with meniscus injuries in our study. Results: The mean operation time was 3.41 h (range, 3-4 h). The mean blood loss was 352.78 ml (range, 300-410 ml). All the injured meniscuses were repaired. All patients were followed up, and the average time of follow up was 16.61 months (range, 14-22 months). Bone union was achieved at a mean of 12 weeks (range, 10-14 weeks). The mean degree of knee extension was 1.11°(range, 0-5°), and the mean degree of knee flexion was 120.56°(range, 110-130°). The mean points of KSS were 83 (range, 74-89 points). According to the criteria of KSS, 14 patients had clinical outcomes rated as excellent and 4 patients were rated as good. Conclusion: Our results suggested that Combined lateral peripatellar and posteromedial approaches in the treatment of Schatzker type IV tibial plateau fractures involving posteromedial plane acquired satisfying outcomes. It was good for repairing the injured meniscus through our approaches.

Posteromedial plate application using medial midline incision for complex tibia plateau fractures: a retrospective study

“…However, there was no necrosis in this patient and the superficial infection was resolved with oral antibiotics. Zhang et al [ 20 ] used combined lateral peripatellar and posteromedial approaches for treatment of Schatzker type IV (medial and posteromedial column) tibial plateau fractures and reported satisfying outcomes. Our series included 10 patients with Schatzker type IV fractures.…”

Posteromedial Buttress Plate for Schatzker 6 Fractures as Double Column Fixation

“…Schatzker Type 6 fractures are complex injuries involving the tibial plateau, which is the flat surface at the top of the tibia bone (16) . These fractures typically result from the trauma such as fall from height or from a motor vehicle accident (17) . The severity of Type 6 fractures can vary, with some cases involving a split in the tibial plateau and others involving significant fragmentation and displacement of the bone.…”

“…Posteromedial buttress plate fixation is a surgical technique used to treat Schatzker type 6 fractures, which involve a complete articular depression of the medial plateau of the tibia. In this procedure, a pre-contoured posteromedial buttress plate is fixed to the tibia using screws to support the medial column of the tibia, which can help restore joint stability and function (2) . A buttress plate is an orthopedic implant composed of a metallic material, usually titanium or stainless steel, that is utilized to provide additional structural support and stabilization to a bone that has been weakened or fracture (3,4) .…”