Treatment of posterolateral tibial plateau fractures through fibular osteotomy approach

Abstract

The best approach for treating posterolateral tibial plateau fractures remains controversial. The aim of the present study was to evaluate the outcomes of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with the fibular osteotomy approach.

Between January 2009 and July 2012, twelve patients with posterolateral tibial plateau fracture were treated using the fibular osteotomy approach with a proximal tibia locking compression plate. The epidemiological data, operation details, and clinical outcomes over 25.6 ± 2.1 months (range, 22-38 months) of follow-up were prospectively collected and analyzed.

The average surgical duration was 92.5 ± 14.5 min (range, 83–107 min). An anatomical reduction rate of 91.7% (11/12) was observed, although one patient with a lateral comminuted fracture and dislocation had a 2-mm joint surface depression postoperatively.

The average fracture healing time was 11.6 ± 3.1 weeks (range, 8-15 weeks), with an average hospital for special surgery knee score of 94.1 ± 3.2 points (range, 80-100 points), an average knee flexion of 118.6° ± 18.1° (range, 96°-138°) and an average knee extension of 1.9° ± 2.2° (range, 0°-6.3°). No complications were found.

The fibular osteotomy approach with a proximal tibial compression plate can produce a satisfactory clinical outcome for patients with posterolateral tibial plateau fractures.