title: A combined posterior reversed L-shaped and anterolateral approach for two column tibial plateau fractures in Caucasians: A technical note.
abstract: OBJECTIVE
  Open reduction and internal fixation of two column posterior and lateral tibial plateau fractures through a combined posterior reversed L-shaped and anterolateral approach in floating position in Caucasians.
  
  
  METHODS
  Two column posterior and lateral tibial plateau fractures.
  
  
  METHODS
  Tibial plateau fractures that do not involve the posterior and lateral column.
  
  
  METHODS
  The patient is positioned in floating position, a reversed L-shaped skin incision is made, the posterior column after lateral retraction of the medial head of the gastrocnemius muscle is exposed, and the posterior fragments are reduced and fixed. Subsequently, flexion and varus stress on the knee is applied, an anterolateral skin incision is made, the lateral column is exposed, and the lateral fragments are reduced and fixed.
  
  
  CONCLUSIONS
  Despite a different physique as Asians, a combined posterior reversed L-shaped and anterolateral approach in a floating position for the surgical treatment of two column posterior and lateral tibial plateau fractures is technically possible in Caucasians. In our experience, this combined approach is an excellent strategy in most patients for surgical treatment of two column posterior and lateral column fractures.
authors.affiliation: University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven - University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium. Electronic address: harm.hoekstra@uzleuven.be.
authors.forename: H
authors.initials: H
authors.lastname: Hoekstra
authors.affiliation: KU Leuven - University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Rosseels
authors.affiliation: Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Department of Orthopedic Surgery, 200233 Shanghai, China.
authors.forename: C-F
authors.initials: CF
authors.lastname: Luo
authors.affiliation: University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven - University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Nijs
mesh_terms: D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D056888:Patient Positioning / Q000379:methods*; D017410:Practice Guidelines as Topic; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Anterolateral approach; Fracture; Knee; Reversed L-shaped approach; Tibial plateau