title: Posterior tibial plateau fracture: a new treatment-oriented classification and surgical management.
abstract: OBJECTIVE
  To establish a classification system for the different types of posterior tibial plateau fractures (PTPF), and to explore the fracture patterns and early results of treatment.
  
  
  METHODS
  39 PTPFs patients who received surgeries through posteromedial or (and) posterolateral knee approaches were analyzed retrospectively.
  
  
  RESULTS
  There were 5 types of PTPFs identified in the new classification system: posteromedial split fracture (type I, 7 patients), posterolateral split fracture (type II, 5 patients), posterolateral depression fracture (type III, 11 patients), posterolateral split and depression fracture (type IV, 2 patients), and posteromedial split combined with posterolateral depression fracture (type V, 14 patients). All patients underwent surgeries safely without complications. The average follow up was 18.1 months (12-30 months). The average weight-bearing durations were 15.6 weeks (12-20 weeks). Based on Rasmussen functional scoring system, 20 cases were regarded as excellent, 14 were good, 5 were fair, and 0 was poor. There was significant change in the Rasmussen functional score before (8.38 ± 2.87) and after surgery (24.20 ± 3.44). According to Rasmussen radiology system, 28 cases were excellent, 8 cases were good, 3 were fair, and none was poor. There was also a significant difference detected between pre-operation (6.77 ± 2.27) and post-operation (16.41 ± 2.65).
  
  
  CONCLUSIONS
  This study presents a new classification system for the different types of PTPFs based on the treatment. The classification is clinically relevant and can be used to guide the surgical management.
authors.affiliation: Department of Orthopedics, Central Hospital of Yiwu City Yiwu, Zhejiang Province, China.
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Affiliated Dongnan Hospital of Xiamen University, Orthopaedic Center of PLA Zhangzhou 363000, China.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang Province, China.
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Yi
keywords: CT scan; Tibia plateau; classification; fracture