An extended anterolateral approach for posterolateral tibial plateau fractures

The best approach for treating posterolateral tibial plateau fractures remains controversial. The clinical results of an extended anterolateral approach on such fractures are discussed in this study. Between 2010 and 2011, ten patients with posterolateral tibial plateau fracture were treated using an extended anterolateral approach with a proximal tibial locking compression plate. The epidemiological data, operation details, and clinical outcomes over 26.4 ± 2.3 months (range 24–30 months) of follow-up were prospectively collected and analyzed. The average surgical duration was 91.5 ± 18.7 min (range 80–130 min). An anatomic reduction rate of 90 % (9/10) was observed although one patient with a lateral comminuted fracture and dislocation presented a 2-mm joint surface depression postoperatively. The average fracture healing time was 10.6 ± 1.8 weeks (range 8–14 weeks), with an average hospital for special surgery knee score of 95.3 ± 6.5 points (range 80–100 points), an average knee flexion of 119.8° ± 17.2° (range 95°–140°) and an average knee extension of 2.1° ± 2.1° (range 0°–6°). No complications were found. The extended anterolateral approach with a proximal tibial compression plate offers direct and complete surgical exposure and may provide an effective method for the surgical treatment of posterolateral tibial plateau fractures. Therapeutic, Level IV.