The posterolateral shearing tibial plateau fracture:

Tao, Jie; Hang, Donghua; Wang, Qiugen; Gao, Wei; Zhu, Libo; Wu, Xiaofeng; Gao, Kan-da

doi:10.1016/j.knee.2008.07.004

Cited by 88 publications

(37 citation statements)

References 12 publications

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“…Isolated posterior column fractures are uncommon [41, 42]. This type of fracture more frequently occurred in our study compared with our another related study (regardless of age) (12.54% vs 7.8%) [15].…”

Section: Discussionsupporting

confidence: 45%

Tibial plateau fractures in elderly people: an institutional retrospective study

Sun

Shu

et al. 2018

J Orthop Surg Res

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BackgroundTibial plateau fractures are the most common intra-articular fractures, which require careful evaluation and preoperative planning. The treatment of tibial plateau fractures in elderly patients is challenging, and the comprehension of epidemiology and morphology can be helpful. This study described the characteristics of geriatric tibial plateau fractures.MethodsA total of 327 (23.24%) patients aged ≥60 years were reviewed in our level one trauma center over a 4-year period (from January 2013 to November 2016). The following parameters were collected and evaluated: (1) demographic data, (2) injury mechanisms and (3) fracture classifications.ResultsFemales accounted for 60.86% in all included elderly patients. Electric-bike accidents were the cause of 32.42% of all these injuries, and 39.62% of these led to high-energy injuries. The most common type of fracture was Schatzker II (54.74%). According to the three-column classification, single lateral column fracture (28.75%) and four-quadrant fracture (involving lateral, medial, posterolateral and posteromedial fractures) (23.24%) were the two most frequent patterns. In all cases, 67.58% involved the posterior column, and the prevalence of posterolateral and posteromedial fractures were 62.69% and 37.92% respectively. Isolated posterior column fractures accounted for 12.54% of patients in total, which mostly consisted of posterolateral fracture in older females (85.37%).ConclusionsThe majority of elderly patients with tibial plateau fractures are females, and Electric-bike accidents are an important cause of injury. Geriatric tibial plateau fractures have unique distribution in classification.

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Section: Discussionsupporting

confidence: 45%

Tibial plateau fractures in elderly people: an institutional retrospective study

Sun

Shu

et al. 2018

J Orthop Surg Res

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“…Frosch et al [8] described a posterolateral approach with a lateral arthrotomy for visualizing the joint surface. Posterolateral approach was modified by Tao [7] with an L-shaped incision. Fibular osteotomy was not required in this approach and it protected the soft tissue well, showing encouraging clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Although surgical approaches have been well discussed in previous studies [4, 7–9], operative fixation in treatment of posterolateral tibial plateau fractures has rarely been reported. No specialized plate is used for the treatment due to the irregular shape of the posterolateral tibial plateau.…”

Section: Discussionmentioning

confidence: 99%

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A new anatomic locking plate for the treatment of posterolateral tibial plateau fractures

Jian

Zhou

et al. 2018

BMC Musculoskelet Disord

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BackgroundPosterolateral tibial plateau fractures have become more common, and their treatment is of great importance to knee function. Additionally, there is no available literature detailing specialized anatomic locking plate for tibial plateau fractures. Therefore, the aim of the study was to evaluate the safety and clinical efficacy of an innovative anatomic locking plate for treatment of posterolateral tibial plateau fractures.MethodsBetween March 2014 and January 2016, 12 patients with posterolateral tibial plateau fracture underwent surgery with the anatomic locking plate for the posterolateral tibial plateau via the posterolateral approach. Relevant operational data for clinical evaluation were collected.ResultsThe mean follow-up time was 26 months, and the mean age was 35 years for 12 patients. The mean interval between the time of injury and the surgery was 6.1 days. Radiological fracture union was evident in all patients at 12 weeks. During surgery, the blood loss ranged from 100 to 300 mL, and the duration ranged from 55 to 90 min. The Tegner–Lysholm functional score ranged from 85 to 97 at the final follow-up. Moreover, the final Rasmussen functional score ranged from 25 to 29, and Rasmussen anatomical score ranged from 13 to 18.ConclusionsThe newly designed anatomic locking plate for the posterolateral tibial plateau provided adequate fixation along the posterolateral tibial plateau. It proved to be safe and effective in a small-sample-size population (12 patients) during a 12- to 34-month follow-up.

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“…Management of bicondylar plateau fractures generally requires two surgical approaches [2, 5, 6, 13, 18, 32]. Multiple studies have reported approaches for posterior plateau fractures, but these approaches are not extensile to access anterior plateau fractures, meniscal pathology, or metaphyseal-diaphyseal fractures [1, 3, 4, 6–8, 12, 18, 19, 22, 23]. Posterior approaches include posteromedial access [29], posterolateral with fibular osteotomy [12, 18, 22, 25], and prone direct posterior access for shear fractures of the plateau [5, 23] and can produce flexion contractures about the knee [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Surgical Technique: Tscherne-Johnson Extensile Approach for Tibial Plateau Fractures

Johnson

Timon

Osuji

2013

Clinical Orthopaedics &Amp; Related Research

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BackgroundThe standard approach to lateral tibial plateau fractures involves elevation of the iliotibial band (IT) and anterior tibialis origin in continuity from Gerdy’s tubercle and metaphyseal flare. We describe an alternative approach to increase lateral plateau joint exposure and maintain iliotibial band insertion to Gerdy’s tubercle.Description of TechniqueThe approach entails a partial tenotomy of the anterior half of the IT band leaving the posterior IT band insertion attached to Gerdy’s tubercle. Fracture lines around Gerdy’s tubercle are completed or the tubercle was osteotomized and externally rotated and the joint overdistracted, allowing direct visualization of the joint depression. Joint elevation, grafting, and internal fixation are performed through this window.MethodsWe retrospectively reviewed 76 patients (two groups), Schatzker Types I to II and IV to VI fractures (66 patients), between 1989 and 2005, and 10 patients, with 10 bicondylar posterior plateau fractures, from 2002 to 2010. All patients were followed a minimum of 12 months (average, 3.9 years; range, 12 months to 10 years). Ten patients, with posterior plateau fractures, received anterolateral plateau intraarticular osteotomy for exposure of centroposterior and posterolateral articular depression.ResultsAverage knee ROM was 2° of flexion (range, −3° to 5°) to greater than 120° of flexion (range, 100°–145°). In 66 patients, average articular depression improved from 7.4 mm to 1 mm (range, 0–5 mm) and, in 10 posterior fractures, from 18 mm to 1 mm (range, 0–4.5 mm). Infection occurred in one of the 76 patients; acute débridement and intravenous antibiotics resulted in control of the infection.ConclusionsThis approach reliably increases direct visualization of the lateral plateau articular fractures and maintains IT band insertion. Articular osteotomy of the anterolateral plateau provides access to extensive posterior plateau fractures.Level of EvidenceLevel IV, retrospective study. See Guidelines for Authors for a complete description of levels of evidence.

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The posterolateral shearing tibial plateau fracture:

Cited by 88 publications

References 12 publications

Tibial plateau fractures in elderly people: an institutional retrospective study

Tibial plateau fractures in elderly people: an institutional retrospective study

A new anatomic locking plate for the treatment of posterolateral tibial plateau fractures

Surgical Technique: Tscherne-Johnson Extensile Approach for Tibial Plateau Fractures

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