Systematization in the approach to tibial plateau fractures

Abstract

Tibial plateau fractures have increased in our country in terms of frequency and complexity, mainly due to motorbike accidents. CT scans have generally contributed to interpreting the fracture pattern.

The study aims to use a grid that includes the different images and allows for the mapping of the different fracture traces. In this way we may define the kind or kinds of approaches to the fracture, the patient’s position on the surgical table and the selection of implants. We emphasize on the posteromedial and posterolateral approaches, recently used in our country.

16 patients with tibial plateau fractures were treated at CAMY health care institution in the city of Young, between January 2015 and June 2017, having studied them with simple x-rays and CT scans. The Schatzker classification was used, although a wider one, which also considered axial plane lesions. In 9 cases it was necessary to perform a posteromedial approach and in 2 cases a posterolateral approach was the one used.

All fractures consolidated and articular mobility was complete in all cases.

Two patients suffered a deep infection and one of them presented a final external popliteal sciatic nerve paralysis.

To conclude, the grid proposed was very useful for the preliminary analysis of these lesions and we point out the importance of the posterolateral and posteromedial approaches when the tibial plateau is compromised.