Floating Position Combined With Inverted L Approach In The Treatment Of The Schatzker?,?-type Tibialplateau Fracturewith The Posterolateral Shearing Tibial Plateau Fracture

A tibial plateau fracture is an intra-articular fracture that always involves various degrees of splitting,depression and displacement,which may influence the stability and movement of the knee joint.A posterolateral shearing tibial plateau fracture is not uncommon.Tibial plateau fractures involving the posterolateral articular surface present a unique challenge to treating surgeons due to the complex anatomy of the region.The posterolateral corner complex and the proximity of the common peroneal nerve restrict the exposure of the joint surface.Further,injury to the soft tissue envelope may prevent use of the optimal surgical incision.There is no consensus on the methods of surgical treatment for posterolateral shearing tibial plateau fracture,including the surgical approach or the fixation strategy.Therefore,posterolateral shearing tibial plateau fracture is still one of the difficulties in department of orthopedics and trauma treatment.Objective:To evaluate the clinical results of floating position combined with inverted L approach in the treatment of the Schatzker?,?-type tibialplateau fracturewith the posterolateral shearing tibialplateau fracture.Methods: In the period of September 2014 to December 2016,10 cases with the Schatzker?,?-type tibialplateau fracturewith the posterolateral shearing tibialplateau fracture were treated by floating position combined with inverted L approach in our hospital.6 males and 4 females;aged 27 to 65 years,mean 44.3 years.The knee function was evaluated using The Rasmussen knee joint function scores,Rasmussen knee joint radlological scores and HSS grading for clinical examination about the kneejoint function at the the 12 th month after operation.The tibial plateau angle,the posterior slope angle were assessed on the X-ray films.Results:All cases were followed up for 12~15 months.Bone union was obtained in all cases.Theresults of Rasmussen knee joint radlological scoresshowed8 caseswere excellent,2 cases were good.Theresults of Rasmussen knee joint function scores criterion showed 6 caseswere excellent,3 cases good and 1 fair.All the results according to HSS grading showed 9 caseswere excellent,1 cases were good.All patients had no significant difference in tibial plateau varus angle and tibial plateau posterior slope between 2 days after operation and 12 months after operation.One case had Incision with exudate,which was cured by conservative treatment.Conclusions:Floating positioncombined with inverted L approach in the treatment of the Schatzker?,?-type tibialplateau fracturewith the posterolateral shearing tibialplateau fracture,which has many advantages such as direct visual reduction,fixation and the excellent clinical result.