Resumo

LUGONES, Alfonso; PIOLI, Ignacio  e  ALLENDE, Bartolomé Luis. Posteromedial approach to reduce and stabilize the posteromedial component in tibial plateau fractures. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.2, pp.144-150. ISSN 1852-7434.

Background: Tibial plateau fractures require different approaches according to the initial fracture pattern. The most widely used classification (Schatzker) is based on the description of anteroposterior lesions, and does not describe the sagittal plane fragments. Posteromedial fragment fractures are secondary to a combination of varus over an axial load with knee hyperextension. The incorrect interpretation of the fracture pattern may lead to an incorrect approach. The aim of this study is to describe the posteromedial approach to the posteromedial fragment in tibial plateau fractures, and describe our experience. Methods: Between January 2005 and March 2009 we evaluated 15 patients -nine male and six female- who were surgically treated with a posteromedial approach for tibial plateau posteromedial fracture fragments. Average age was 38.9 years. No fracture was open. Twelve fractures were bicondylar. Results: Average follow-up was 16.1 months, with no perioperative complications, non-unions or malunions. We evaluated the reduction quality following DeCoster: five were anatomic, seven were good and three were fair. Conclusions: We believe that the posteromedial approach to treat tibial plateau posteromedial fracture fragments is highly effective and reproducible, and offers satisfactory vision to perform a correct treatment.

Palavras-chave : Tibial plateau fractures; Posteromedial fragment; Posteromedial approach.

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