Abstract：Objective To investigate the surgical technique and clinical outcome of posteromedial approach in treatment of posteromedial tibial plateau split fractures. Methods A retrospective review was performed on 36 cases of posteromedial tibial plateau split fractures operated via posteromedial approaches from January 2006 to November 2011. There were 23 males and 13 females, at age range of 21-70 years (average 40.1 years). Mechanism of injury was traffic accidents in 19 cases, a high fall in 10, slipping on the ground in five and sports in two. The fractures were all fresh closed fractures. Period from injury to operation was 2-16 days. CT classification of the fracture was 11 cases of posteromedial split fracture and 25 cases of posteromedial split and posterolateral depression fracture. Preoperative evaluation included anteroposterior and lateral radiography, CT scan and three-dimensional reconstruction. Results All 36 cases were followed up for 12-32 months (average 17.5 months), which showed none of following complications: incision infection, cutaneous necrosis, implant loosening or breakage, bone disunion, knee inversion or eversion and fracture redisplacement. One case presented with anesthesia at posterior lower part of the calf, but restored completely after three months of symptomatic nerve nourishment using mecobalamin. Posteriomeidal fractures obtained anatomical reduction. Joint function as assessed by Rasmussen criteria was excellent in 21 cases, good in 13 and fair in 2, with excellence rate of 94%. Conclusion Posteromedial approach is an ideal procedure for treatment of posteromedial tibial plateau split fractures, for its advantages over direct and complete exposure, minor soft tissue injury and absence of injury to major vascular nerves.
CHEN Hong-wei,KUANG Hong,PAN Jun et al. Posteromedial approach for treatment of posteromedial tibial plateau split fractures[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(9): 853-856.
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