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
