• V Zimmermann.
• Unfallchirurgie und Orthopädische Chirurgie, Schwerpunkt Hand- und Wirbelsäulenchirurgie, Klinikum Traunstein, Cuno-Niggl-Straße 3, 83278, Traunstein, Deutschland, volker.zimmermann@klinikum-traunstein.de.
• Unfallchirurg. 2014 Jan 1; 117 (1): 414741-7.

BackgroundTibial plateau fractures overall and especially in winter sports are rare. However, the incidence in recent years is increasing. In a retrospective study from 2009-2012, we found 52 injuries affiliated with winter sports. Noticeable was the high rate of severe injury patterns. In 20 of the 52 cases, there were complete articular or bicondylar fractures (38 %). In 25 cases (48 %), fragment dislocation corresponding to the Moore classification was observed.MethodsThe operative algorithm was based on the initial soft tissue damage and the type of fracture. A two or more stage procedure with first line soft tissue management and temporary external fixation stabilization was performed 12 times. The final internal osteosynthesis was based on the morphology of the fracture, i.e., direct exposition and stabilization of relevant fracture patterns. In 24 cases (46 %), there was a need for two (or more) approaches. In the anterior aspect of the tibial head, customary implants were used; posterior pathologies were stabilized with low-dimension implants.ResultsSummarizing with regard to the literature, there is a more discriminating view of tibial plateau fractures, regarding all relevant fracture patterns. Thus, different options in operative access and choice of implants can be made.

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