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Approaches and fixation of the posterolateral fracture fragment in tibial plateau fractures: a review with an emphasis on rim plating via modified anterolateral approach

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Abstract

Purpose

To review available approaches and fixation methods for posterolateral fracture fragment (PLF) in tibial plateau fracture, and to propose an algorithm to treat various types of plateau fractures which all involve the PLF.

Methods

This article reviews multiple surgical approaches for PLF and suggests an algorithm for suitable approach and fixation method according to PLF with combined plateau fracture.

Results

The modified anterolateral approach is a suitable single approach for fractures with a PLF combined with an anterolateral plateau fracture and for isolated posterolateral fracture fragments. For a multicolumn tibia plateau fracture involving the lateral, medial and posterior columns, dual approaches (modified anterolateral and posteromedial approach) can be used to access the entire plateau area.

Conclusions

When considering approaches of this complex fracture pattern, one must consider local soft tissue condition, plateau fracture morphology, associated injuries, and fixation options. After review of multiple approaches described in the literature for PLF fixation, we can suggest an algorithm for the approach and fixation to treat tibial plateau fractures with posterolateral fracture fragments.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Guro Hospital, Korea University Medical Center, 148, Gurodong-ro, Guro-gu, Seoul, South Korea

    Jae-Woo Cho, Jinil Kim, Won-Tae Cho, Jin-Kak Kim, Puspak Samal, Pranay H. Gujjar, William T. Kent & Jong-Keon Oh

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  1. Jae-Woo Cho
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  2. Jinil Kim
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  3. Won-Tae Cho
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Correspondence to Jong-Keon Oh.

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Cho, JW., Kim, J., Cho, WT. et al. Approaches and fixation of the posterolateral fracture fragment in tibial plateau fractures: a review with an emphasis on rim plating via modified anterolateral approach. International Orthopaedics (SICOT) 41, 1887–1897 (2017). https://doi.org/10.1007/s00264-017-3563-6

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  • DOI: https://doi.org/10.1007/s00264-017-3563-6

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