Abstract

ROBLEDO-HERRERA, O; DIEGO-BALL, D  and  OLIVA-RAMIREZ, S. Posteromedial approach and plating for a tibial plateau fracture with a posterior fragment. Acta ortop. mex [online]. 2015, vol.29, n.2, pp.69-76. ISSN 2306-4102.

Background: Tibial plateau fractures account for 1% of all fractures. Ten percent of them involve the medial plateau. The spectrum of lesions ranges from undisplaced fractures to devastating fractures involving the entire tibial plateau, which warrant extensive surgical management. The orthopedic surgery literature suggests that positive functional and radiographic results depend on the type of approach, the quality of reduction and the type of implant used. Material and methods: Ambispective case report: seven patients were enrolled, with fracture of the medial tibial plateau and a posterior fragment. A posterior plate was placed after a posteromedial approach, between August 2012 and August 2013. Fractures were staged according to the Khan classification. Functional and radiographic results were assessed using the Rasmussen scale. Frequency and descriptive statistics were used. Results: Pain was measured using a visual analog scale (VAS), with scores ranging from two to four. Flexion ranged between 40^o and 110^o, with a minimum extension deficit of 15^o and a maximum of 40^o. Four subjects had varus deformity, three had valgus deformity. Conclusions: The posteromedial approach and placement of a posterior plate for tibial plateau fractures results in ranges of motion that permit an appropriate function and involve mild pain. Varus angulation occurs in patients with bilateral tibial plateau fractures.

Keywords : fracture; tibial plateau; pain; visual analog scale (VAS); posteromedial approach.