Top

Published in:

01-09-2017 | Review Article

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

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

Published in: International Orthopaedics | Issue 9/2017

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.

Xiang G, Zhi-Jun P, Qiang Z, Hang L (2013) Morphological characteristics of posterolateral articular fragments in tibial plateau fractures. Orthopedics 36(10):e1256–e1261. doi:10.3928/01477447-20130920-16 CrossRefPubMed

Partenheimer A, Gosling T, Muller M, Schirmer C, Kaab M, Matschke S, Ryf C, Renner N, Wiebking U, Krettek C (2007) Management of bicondylar fractures of the tibial plateau with unilateral fixed-angle plate fixation. Unfallchirurg 110(8):675–683. doi:10.1007/s00113-007-1271-1 CrossRefPubMed

Sohn HS, Yoon YC, Cho JW, Cho WT, Oh CW, Oh JK (2015) Incidence and fracture morphology of posterolateral fragments in lateral and bicondylar tibial plateau fractures. J Orthop Trauma 29(2):91–97CrossRefPubMed

Houben PF, van der Linden ES, van den Wildenberg FA, Stapert JW (1997) Functional and radiological outcome after intra-articular tibial plateau fractures. Injury 28(7):459–462CrossRefPubMed

Singleton N, Sahakian V, Muir D (2017) Outcome after tibial plateau fracture: how important is restoration of articular congruity? J Orthop Trauma 31(3):158–163CrossRefPubMed

Waldrop JI, Macey TI, Trettin JC, Bourgeois WR, Hughston JC (1988) Fractures of the posterolateral tibial plateau. Am J Sports Med 16(5):492–498CrossRefPubMed

Cole PA, Zlowodzki M, Kregor PJ (2004) Treatment of proximal tibia fractures using the less invasive stabilization system—surgical experience and early clinical results in 77 fractures. J Orthop Trauma 18(8):528–535. doi:10.1097/00005131-200409000-00008 CrossRefPubMed

Manidakis N, Dosani A, Dimitriou R, Stengel D, Matthews S, Giannoudis P (2010) Tibial plateau fractures: functional outcome and incidence of osteoarthritis in 125 cases. Int Orthop 34(4):565–570. doi:10.1007/s00264-009-0790-5 CrossRefPubMed

Solomon LB, Stevenson AW, Lee YC, Baird RP, Howie DW (2013) Posterolateral and anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study. Injury 44(11):1561–1568. doi:10.1016/j.injury.2013.04.024 CrossRefPubMed

10.

Carlson DA (2005) Posterior bicondylar tibial plateau fractures. J Orthop Trauma 19(2):73–78CrossRefPubMed

11.

Yu BQ, Han KW, Zhan C, Zhang CC, Ma H, Su JC (2010) Fibular head osteotomy: a new approach for the treatment of lateral or posterolateral tibial plateau fractures. Knee 17(5):313–318. doi:10.1016/j.knee.2010.01.002 CrossRefPubMed

12.

Frosch KH, Balcarek P, Walde T, Sturmer KM (2010) A new posterolateral approach without fibula osteotomy for the treatment of tibial plateau fractures. J Orthop Trauma 24(8):515–520. doi:10.1097/BOT.0b013e3181e5e17d CrossRefPubMed

13.

Bhattacharyya T, McCarty LP 3rd, Harris MB, Morrison SM, Wixted JJ, Vrahas MS, Smith RM (2005) The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. J Orthop Trauma 19(5):305–310PubMed

14.

Trickey EL (1968) Rupture of the posterior cruciate ligament of the knee. J Bone Joint Surg (Br) 50(2):334–341

15.

Tao J, Hang DH, Wang QG, Gao W, Zhu LB, Wu XF, Gao KD (2008) The posterolateral shearing tibial plateau fracture: treatment and results via a modified posterolateral approach. Knee 15(6):473–479. doi:10.1016/j.knee.2008.07.004 CrossRefPubMed

16.

Luo CF, Sun H, Zhang B, Zeng BF (2010) Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 24(11):683–692. doi:10.1097/BOT.0b013e3181d436f3 CrossRefPubMed

17.

Cho JW, Samal P, Jeon YS, Oh CW, Oh JK (2016) Rim plating of Posterolateral fracture fragments (PLFs) through a modified anterolateral approach in tibial plateau fractures. J Orthop Trauma 30(11):e362–e368. doi:10.1097/BOT.0000000000000638 CrossRefPubMed

18.

Zhang W, Luo CF, Putnis S, Sun H, Zeng ZM, Zeng BF (2012) Biomechanical analysis of four different fixations for the posterolateral shearing tibial plateau fracture. Knee 19(2):94–98. doi:10.1016/j.knee.2011.02.004 CrossRefPubMed

19.

Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, Mavrogenis AF, Korres DS, Soucacos PN (2006) Complications after tibia plateau fracture surgery. Injury 37(6):475–484. doi:10.1016/j.injury.2005.06.035 CrossRefPubMed

20.

Sassoon AA, Torchia ME, Cross WW, Cass JR, Sems SA (2014) Fibular shaft allograft support of posterior joint depression in tibial plateau fractures. J Orthop Trauma 28(7):e169–e175. doi:10.1097/bot.0000000000000020 CrossRefPubMed

21.

Chen HW, Zhou SH, Liu GD, Zhao X, Pan J, Ou S, Fei J (2015) An extended anterolateral approach for posterolateral tibial plateau fractures. Knee Surg Sports Traumatol Arthrosc 23(12):3750–3755. doi:10.1007/s00167-014-3304-y CrossRefPubMed

22.

Bermudez CA, Ziran BH, Barrette-Grischow MK (2008) Use of horizontal rafting plates for posterior elements of complex tibial plateau fractures: description and case reports. J Trauma 65(5):1162–1167. doi:10.1097/01.ta.0000222943.45563.b5 CrossRefPubMed

23.

Lobenhoffer P, Gerich T, Bertram T, Lattermann C, Pohlemann T, Tscheme H (1997) Particular posteromedial and posterolateral approaches for the treatment of tibial head fractures. Unfallchirurg 100(12):957–967CrossRefPubMed

24.

Tscherne H, Lobenhoffer P (1993) Tibial plateau fractures. Management and expected results. Clin Orthop Relat Res (292):87–100

25.

Solomon LB, Stevenson AW, Baird RP, Pohl AP (2010) Posterolateral transfibular approach to tibial plateau fractures: technique, results, and rationale. J Orthop Trauma 24(8):505–514. doi:10.1097/BOT.0b013e3181ccba4b CrossRefPubMed

26.

Sun H, Luo C-F, Yang G, Shi H-P, Zeng B-F (2013) Anatomical evaluation of the modified posterolateral approach for posterolateral tibial plateau fracture. Eur J Orthop Surg Traumatol 23(7):809–818CrossRefPubMed

27.

Marsh J, Slongo TF, Agel J, Broderick JS, Creevey W, DeCoster TA, Prokuski L, Sirkin MS, Ziran B, Henley B (2007) Fracture and dislocation classification compendium-2007: Orthopaedic trauma association classification, database and outcomes committee. J Orthop Trauma 21(10):S1–S6CrossRefPubMed

28.

Heidari N, Lidder S, Grechenig W, Tesch NP, Weinberg AM (2013) The risk of injury to the anterior tibial artery in the posterolateral approach to the tibia plateau: a cadaver study. J Orthop Trauma 27(4):221–225CrossRefPubMed

29.

Chang S-M, Zheng H-P, Li H-F, Jia Y-W, Huang Y-G, Wang X, Yu G-R (2009) 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 129(7):955–962CrossRefPubMed

30.

Hu S-J, Chang S-M, Zhang Y-Q, Ma Z, Du S-C, Zhang K (2016) The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: a novel surgical technique. Injury 47(2):502–507CrossRefPubMed

31.

Pires RES, Giordano V, dos Santos JK, Labronici PJ, de Andrade MAP, de Toledo Lourenço PRB (2015) Expanding indications of the horizontal belt plate: a technical note. Injury 46(10):2059–2063CrossRefPubMed

Title: Approaches and fixation of the posterolateral fracture fragment in tibial plateau fractures: a review with an emphasis on rim plating via modified anterolateral approach
Authors: Jae-Woo Cho
Jinil Kim
Won-Tae Cho
Jin-Kak Kim
Puspak Samal
Pranay H. Gujjar
William T. Kent
Jong-Keon Oh
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3563-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2017

The incidence of life threatening iatrogenic vessel injury following closed or open reduction and internal fixation of intertrochanteric femoral factures

Intramedullary nailing of tibial shaft fractures in the semi-extended position using a suprapatellar portal technique

Quality, cost and outcomes measures in orthopaedic healthcare

Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates

Radiological study of the secondary reduction effect of early functional exercise on displaced intra-articular calcaneal fractures after internal compression fixation

Use of internal lengthening nails in post-traumatic sequelae