A rotational support plate for posterolateral tibial plateau fractures through anterolateral approach / 中华骨科杂志

ABSTRACT

Objective To introduce the operation method of a rotational support plate through a traditional anterolateral approach for posterolateral tibial plateau fractures and analyze the postoperative outcome.Methods From May 2016 to September 2017,10 patients with posterolateral tibial plateau fractures who underwent surgery with the rotational support plate were retrospectively analyzed.There were 6 males and 4 females,aged from 23-66 years (average,46.2 years).The causes of the fractures included traffic accident in 4 cases,fall from height in 5 cases and falling injury in 1 case.According to AO-OTA classification,there were 1 case of 41-B2,8 cases of 41-B3 and 1 case of 41-C3.According to Schatzker classification,there were 6 cases of type Ⅱ,1 was of type Ⅲ,2 were of type Ⅴ,and 1 was of type Ⅵ.Four cases suffered multiple fractures.One patient suffered pelvic fracture,ipsilateral femoral shaft and medial malleolus fracture;One patient suffered ipsilateral tibiofibular fracture;1 patient suffered ipsilateral fibular head and medial femoral epicondyle fracture;One patient suffered ipsilateral fibular head fracture.Fracture healing time,complications,knee range of motion,Hospital for Special Surgery (HSS) knee score were recorded to evaluate postoperative outcomes.Results All 10 patients were followed up for 15.25 months (range,12-27 months).The bony union time ranged from 3.0-4.5 months (average,3.2 months).The range of motion of the knee joint was 105°-161.4° (average,139.9°).According to the HSS system,the score was 64-98 (average,88),including 8 of excellent and 2 of fair.No skin necrosis,incision infections,or fixation failure occurred during follow-up.Conclusion Fixation of posterolateral tibial plateau fracture was successfully achieved using the newly designed plate through a traditional anterolateral approach.It has many advantages such as reliable fixation,satisfying recovery,simplicity of operator,and small tissue damage.