Treatment Of Posterolateral Fracture Of The Tibial Plateau Via The Posterolateral Approach In The Prone Position

Background:Tibial plateau fracture has many different forms, based on anteroposterior tibial plateau X-ray. Schatzker classification is the most used in tibial plateau fractures. Posterolateral fracture or coronal fractures were not included in the classification system, this type of fracture may occur alone, but also as a part of condylar fracture. Due to the location of fracture was blocked by fibula, adjacent blood vessels and nerves, make the reduction and internal fixation difficult. Once the fracture has not been timely and correct treatmented, the articular surface will be rough,even collapse, resulting in knee dysfunction. Therefore, tibial plateau fracture of lateral condyle is still one of the difficulties in department of orthopedics and trauma treatment.[Objective] To explore the clinical effects of posterolateral approach in the prone position in the treatment of posterolateral tibial plateau fracture.[Methods] From January 2010 to July 2013, 22 cases of the lateral tibial plateau fracture were treated(16 males and 6 females; aged 27 to 60 years, mean 42.3 years)via the posterolateral approach in the prone position.[Results] 17 patients were followed up for 12-20 months, average 16.2 months, 5 patients were lost to follow-up.All wounds were healed, no fixation failure cases occurred.The average fracture healing time was 14.2 weeks(range11 to 16 weeks).,full loading times were 16.4 weeks(13 to 20 weeks). According to HSS score, the average points was 85.5(range 70 to 93) after 12 months of surgery.[Conclusion] In the treatment of posterolateral tibial plateau fracture, posterolateral approach in the prone position is a effective method with less soft tissue injury, reduction of skin necrosis,higher rate of fracture healing and functional recovery advantages. In addition to this,we can directly reduct and fix the fractures outside, avoiding damage to the peroneal nerve.