• Yang Zheng, Jiu-Dan Zhang, Jian-Jian Shen, and Jie-Feng Huang.
• Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Shangcheng District, Hangzhou 310006, China. Electronic address: 360847273@qq.com.
• Injury. 2021 Apr 1; 52 (4): 1074-1078.

AbstractThree-column classification of tibial plateau fractures is based on computerized tomography (CT) images, and the patients with three-column fractures can be treated with posteromedial combined with anterolateral approach in the floating position. However, there are certain disadvantages to operating in a "floating position". Therefore, we proposed an "out-in" position for those fractures. The patient is placed in supine position on the operating table, and the healthy hip is elevated. For the posteromedial approach, the affected limb should be placed on a rectangular fluoroscopy table and kept in abduction and external rotation (out); for the anterolateral approach, the affected limb is retracted into the operating bed and kept in neutral position (in).This position has been shown to be highly effective for easy operation as well as intraoperative image monitoring. Furthermore, it highlights the advantage of anterior-posterior joint fracture reduction.Copyright © 2020 Elsevier Ltd. All rights reserved.

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