Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 3/2018

01-06-2018 | Original Article

The anatomical relationship of the neurovascular structures in direct posterior lateral gastrocnemius split approach for posterolateral tibial plateau fractures

Authors: G. Özdemir, B. Yilmaz, E. Şirin, E. N. Keskinöz, G. Kırıkçı, A. Bayramoğlu

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2018

Login to get access

Abstract

Purpose

To evaluate the distances between the incision and neurovascular structures in direct posterior split-gastrocnemius approach for tibial plateau fractures.

Methods

Thirteen fresh-frozen cadavers were used in the study. The distance between the neurovascular structures medial and lateral to the incision was measured from the tibial joint line and at a level 5 cm distal to the joint line.

Results

The mean distance between the incision and medial neurovascular structures was 10.09 ± 3.47 mm (range 5.63–16.51 mm) at the level of the tibial joint line and 10.39 ± 2.57 mm (range 5.79–14.09 mm) at a level 5 cm distal to the joint line. The mean distance between the incision and the common peroneal nerve was 13.44 ± 4.17 mm (range 6.28–20.72 mm) at the level of the tibial joint line and 19.56 ± 5.24 mm (range 12.58–26.74 mm) at a level 5 cm distal to the joint line.

Conclusions

In isolated posterolateral tibial plateau fractures, it is possible to apply anatomical reduction and buttress plating on the posterior surface with a direct posterior split-gastrocnemius approach. With a thorough understanding of the regional anatomy, this approach can be safely performed by experienced orthopaedists.
Literature
1.
2.
Zhang W, Luo CF, Putnis S, Sun H, Zeng ZM, Zend BF. Biomechanical analysis of four different fixations for the posterolateral shearing tibial plateau fracture. Knee. 2012;19(2):94–8.CrossRefPubMed
3.
Lobenhoffer P, Gerich T, Bertram T, Latterman C, Pohlemann T, Tscherne H. Particular postero-lateral approaches for treatment of tibial head fractures. Unfallchirurg. 1997;100:957–67.CrossRefPubMed
4.
Solomon LB, Stevenson AW, Baird RP, Pohl AP. Posterolateral transfibular approach to tibial plateau fractures: technique, results, and rationals. J Orthop Trauma. 2010;24:505–14.CrossRefPubMed
5.
Bhattacharyya T, McCarty LP III, Harris MB, Morrison S, Wixted JJ, Vrahas MS, et al. The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. J Orthop Trauma. 2005;19(5):305–10.PubMed
6.
7.
Tao J, Hang DH, Wang QG, Gao W, Zhu LB, Wu XF, et al. The posterolateral shearing tibial plateau fracture: treatment and results via a modified posterolateral approach. Knee. 2008;15:473–9.CrossRefPubMed
8.
Yu GR, Xia J, Zhou JQ, Yang YF. Low-energy fracture of posterolateral tibia plateau: treatment by a posterolateral prone approach. J Trauma Acute Care Surg. 2012;72(5):1416–23.CrossRefPubMed
9.
Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968–1975. Clin Orthop Relat Res. 1979;138:94–104.
10.
Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, et al. Fracture and Dislocation Classification Compendium—2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee. J Orthop Trauma. 2007;21(10 Suppl):S1–163.CrossRefPubMed
11.
Lowe JA, Tejwani N, Yoo B, Wolinsky P. Surgical techniques for complex proximal tibial fractures. J Bone Jt Surg Am. 2011;93(16):1548–59.
12.
13.
Chang SM, Zheng HP, Li HF, Jia YW, Huang YG, Wang X, et al. Treatment of isolated posterior coronal fracture of the lateral tibial plateau through posterolateral approach for direct exposure and buttress plate fixation. Arch Orthop Trauma Surg. 2009;129:955–62.CrossRefPubMed
14.
15.
Metadata
Title
The anatomical relationship of the neurovascular structures in direct posterior lateral gastrocnemius split approach for posterolateral tibial plateau fractures
Authors
G. Özdemir
B. Yilmaz
E. Şirin
E. N. Keskinöz
G. Kırıkçı
A. Bayramoğlu
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2018
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-017-0790-x

Other articles of this Issue 3/2018

European Journal of Trauma and Emergency Surgery 3/2018 Go to the issue

Review Article

Pediatric head trauma: an extensive review on imaging requisites and unique imaging findings

Editorial

Novel concepts related to inflammatory complications in polytrauma

Original Article

Danger signals from mitochondrial DAMPS in trauma and post-injury sepsis

Review Article

Long-term follow-up of 1217 consecutive short-stem total hip arthroplasty (THA): a retrospective single-center experience

Review Article

Clinical outcomes and effect of delayed intervention in patients with hollow viscus injury due to blunt abdominal trauma: a systematic review

Original Article

Fall from heights: does height really matter?