Special Techniques for Managing Problem Fractures about the Knee

Fractures about the knee can present complex problems for the knee surgeon. The anatomy, while familiar to knee surgeons, presents many challenges in fracture fixation and requires approaches that are not commonly performed by arthroplasty and sports surgeons. Maneuvering around tendons and ligaments to place plates or screws across a fracture may be quite difficult for even experienced surgeons. Massive bone loss, which can also occur with periarticular fractures, presents another set of challenges, especially in osteoporotic bone. Comminuted patella fractures, which offer limited options for fixation, can be difficult to treat so that a functional result is achieved.

In this series, Drs. Buck and Murtha offer a review of various methods to address bone loss about the knee to include osteoarticular bone loss. Dr. Kfuri et al describe an extended anterolateral approach to the proximal tibia, which may be useful for complex lateral plateau fractures. Drs. Volgas and Dreger describe the use of the mesh plate for comminuted fractures of the patella. The authors hope that you, the reader, find these articles useful as you consider various management options for these complicated injuries.