Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/81246
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Posterolateral and anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study
Author: Solomon, L.
Stevenson, A.
Lee, Y.
Baird, R.
Howie, D.
Citation: Injury-international Journal of the Care of the Injured, 2013; 44(11):1561-1568
Publisher: Elsevier Sci Ltd
Issue Date: 2013
ISSN: 0020-1383
1879-0267
Statement of
Responsibility: 
Lucian B. Solomon, Aaron W. Stevenson, Yu C. Lee, Robert P.V. Baird, Donald W. Howie
Abstract: BACKGROUND: Lateral tibial plateau fractures that are located posterolaterally are difficult to reduce through an anterolateral surgical approach because of the lack of direct visualisation of the fracture. This study compared the results of unicondylar posterolateral tibial plateau fractures in two patient cohorts: one treated through a posterolateral direct approach and the other through an anterolateral indirect approach. PATIENTS AND METHODS: All nine patients admitted to our hospital, a tertiary care, urban, public hospital in Australia, from 2007 to 2010 with unicondylar posterolateral tibial plateau fractures were treated through a direct posterolateral transfibular approach and prospectively studied. All eight patients admitted from 2004 to 2007 with unicondylar posterolateral tibial plateau fractures were treated through an indirect anterolateral approach and retrospectively reviewed. Fracture reduction and maintenance of reduction were assessed radiographically over 2 years. Knee function was assessed clinically and using the Lysholm score. RESULTS: Fractures managed through a direct posterolateral transfibular approach were reduced with no measurable articular step on standard radiography and had no loss of reduction over time. By contrast, fractures treated through an indirect anterolateral approach had a median postoperative articular step of 5.5mm (interquartile range=4.5). These displacements worsened over time in six of the eight patients. At 2 years, patients treated through a direct approach had significantly better Lysholm scores than those treated through an indirect approach. CONCLUSION: This study suggests that a direct posterolateral transfibular approach to unicondylar posterolateral tibial plateau fractures results in improved reduction, stabilisation and functional outcomes at early follow-up compared to an indirect anterolateral approach.
Keywords: Fracture fixation; Surgical approach; Tibial fractures; Knee
Rights: Crown copyright © 2013
RMID: 0020132176
DOI: 10.1016/j.injury.2013.04.024
Appears in Collections:Orthopaedics and Trauma publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.