• Peter Behrendt, Markus T Berninger, Grégoire Thürig, Julius Dehoust, Jan H Christensen, Karl-Heinz Frosch, Matthias Krause, and Maximilian J Hartel.
• Department of Trauma Surgery, Orthopedics and Sports Orthopedics, Asklepios St. Georg, Hamburg, Germany. peter.behrendt.kiel@gmail.com.
• Eur J Trauma Emerg Surg. 2023 Feb 1; 49 (1): 201207201-207.

IntroductionThe aim of this study was to compare the reduction quality of the anterolateral (AL) and modified posterolateral approach (PL) in lateral tibial plateau fractures involving the posterior column and central segments.MethodsMatched pairs of pre-fractured cadaveric tibial plateau fractures were treated by either AL approach (supine position) or PL approach (prone position). Reduction was controlled by fluoroscopy and evaluated as satisfying or unacceptable. Afterwards, the reduction was examined by 3D scan.Results10 specimens (3 pairs 41B3.1, 2 pairs 41C3.3) were evaluated. PL approach achieved significantly (p 0.00472) better fracture reduction results (0.4 ± 0.7 mm) of the posterior column compared to the AL group (2.1 ± 1.4 mm). Fracture steps involving the central area of the lateral plateau were insufficiently reduced after fluoroscopy using both approaches.ConclusionOptimal reduction of displaced tibial plateau fractures involving the posterolateral column necessitates a posterior approach, which can be conducted in prone or lateral positioning. The anterolateral approach is indicated in fractures with minor displacement of the posterolateral rim but fracture extension in the latero-central segments. In these cases, an additional video-assisted reduction or extended approaches are helpful.© 2022. The Author(s).

17 keywords...

hide…