Direct Posterior Approach for Management Of Posteromedial Tibial Plateau Fracture using Buttress Plate (Schatzker IV, V, VI)

Abstract

Tibial plateau fractures have always been a challenge for orthopaedic surgeons. These fractures may be difficult to manage and, although these lesions are relatively rare representing approximately 1% of all fractures , the consequences of an inadequate treatment can be serious.

There have been in the past, there are now and there will be in the future controversies regarding the best method of treatment. Several choices have been considered in the treatment of these fracture and numerous satisfactory results have been reported using both non-surgical and surgical methods .

In any case, the goals of treatment are restoration of normal alignment, joint congruity, joint stabilization and, ultimately, the prevention of degenerative osteoarthritis. A precise reduction and a stable fixation of the fracture fragments, obtained through out a good visualization of the articular surface with minimal dissection, can help to achieve these goals and allows early mobilization and a faster recovery.

Tibial plateau fractures are often the consequence of a high-energy trauma and present a wide spectrum of bone and soft tissue injury patterns and, not rarely, are associated with intra-articular lesions. Minimally invasive surgical techniques have gained popularity over the recent years and try to prevent additional surgical trauma to the knee joint by using a minimally invasive approach.

These surgical techniques fall in between the management of unstable tibial plateau fractures by plaster cast immobilization (higher risks of stiffness and deep