Clinical Outcomes of Fixation of Depressed Posterolateral Tibial Plateau Fractures Using a Direct Lateral Approach.

Abstract

Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results. Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up. The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6-7) vs. 7 (6-8, <i>p</i> = 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (<i>p</i> < 0.001). The full range of motion was seen in all patients except one who was manipulated after three months. Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures. IV.