title: Fracture of the anteromedial tibial plateau associated with posterolateral complex injury: case study and literature review.
abstract: We report an unusual case of anteromedial tibial plateau compression fracture following hyperextension and forced varus of the knee, resulting in an anterior bone fragment large enough to require osteosynthesis. This uncommon lesion was associated with posterolateral complex injury, diagnosed with magnetic resonance imaging (MRI), while both cruciate ligaments were preserved. After proceeding with tibial plateau osteosynthesis, a peroneal tendon allograft was used for supplementation repair of the lateral collateral ligament and biceps tendon in a single surgical intervention. Tibial plateau fractures are often associated with soft-tissue involvement, mainly of the anterior cruciate ligament and external meniscus. Posterolateral complex injuries also occur with a mechanism of forced varus and hyperextension. These lesions require an accurate diagnosis to avoid future knee instability; moreover, adequate treatment in the acute phase provides a better functional outcome. Physicians should suspect associated posterolateral complex injury when an anteromedial tibial plateau fracture is diagnosed. MRI allows adequate diagnosis and permits surgical treatment in one procedure.
authors.affiliation: Department of Orthopedics and Traumatology, Hospital Municipal de Badalona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Conesa
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Minguell
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Cortina
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Castellet
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Carrera
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Nardi
authors.affiliation: Department of Knee Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Cáceres
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D064591:Allografts; D017885:Collateral Ligaments / Q000293:injuries* / Q000601:surgery*; D005593:Fracture Fixation, Internal; D050815:Fractures, Compression / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007718:Knee Injuries / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009049:Motorcycles; D012421:Rupture; D013708:Tendon Injuries / Q000209:etiology / Q000601:surgery*; D013709:Tendon Transfer; D013978:Tibial Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed