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J Knee Surg 2020; 33(07): 646-654
DOI: 10.1055/s-0039-1683927
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Modified Direct Posterior Midline Approach for the Treatment of Posterior Column Tibial Plateau Fractures

Zhaowei Yin   *
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Wengbo Yang   *
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Yanqing Gu
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Qiangrong Gu
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Chenyang Xu
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Lei Yang
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Chunzhi Jiang
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
,
Bin Liang
1   Department of Orthopaedic, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
› Author Affiliations Funding None.
Further Information

Publication History

06 June 2018

05 February 2019

Publication Date:
27 March 2019 (online)

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Abstract

The purpose of this study was to introduce a modified surgical approach for the treatment of posterior column tibial plateau fractures. Fifteen patients with posterior column fractures with or without other column fractures were included and treated with this approach between July 2015 and June 2016. The patients were followed up for 18 to 24 months (20.9 ± 1.8 months). Outcomes included neural or vascular injuries, wound complications, nonunion, plate loosening or breakage, and Hospital for Special Surgery (HSS) scores. Bone union was observed in all cases, and the average time for bone union was 13.5 ± 1.4 weeks (11–16 weeks). No neurovascular injuries, malunion, nonunions, or plate loosening or breakages were observed. The average HSS score was 94.7 ± 4.1 (range: 84–100). The modified direct posterior midline approach can provide excellent exposure and facilitate reduction and internal fixation of posterior column fractures of the tibial plateau, including split and depressed fractures. We expect that this approach can be used as a new effective method for managing complex posterior tibial fractures.

Keywords

tibial plateau fractures - posterior approach - classification - surgical approach

Note

This article does not contain any studies with human participants or animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.


* These authors contributed equally to this work.


 

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