title: An Innovative Intra-articular Osteotomy in the Treatment of Posterolateral Tibial Plateau Fracture Malunion.
abstract: Posterolateral tibial plateau fractures are not uncommon and the diagnosis can be easily missed. The treatment is technically demanding, which can easily lead to malunion of the posterolateral tibial plateau fracture. Here, we describe an innovative intra-articular osteotomy for the treatment of posterolateral tibial plateau fracture malunion. From 2010 through 2012, 13 patients with a posterolateral tibial plateau fracture malunion were treated in our trauma center. The patients were referred because of instability or knee pain. The instability was confirmed by physical examinations preoperatively. The depression malunion and lower limb alignment were evaluated on X-rays and computed tomography scans. All posterolateral tibial plateau fracture malunions were treated with an innovative intra-articular osteotomy via an extended anterolateral approach. The mean follow-up was 19.6 months (range, 14-28 months). The posterolateral osteotomy healed at an average of 15.1 weeks. The depression malunion was corrected in all patients, which was from 15.4 mm preoperatively to 3.3 mm at 12 months postoperatively. The average Lysholm, Knee Society Score, and visual analog scale scores were 91.7, 92.5, and 0.5, respectively. No loss of reduction, nonunion, or wound infection was observed. An innovative intra-articular osteotomy via an extended anterolateral approach is an effective treatment for posterolateral tibial plateau fracture malunion. The treatment achieved satisfactory functional results and knee stability restoration.
authors.affiliation: Department of Orthopedic Trauma, Shanghai JiaoTong University Affiliated Shanghai Sixth People's Hospital, Shanghai, China.
authors.forename: Yukai
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Trauma, Shanghai JiaoTong University Affiliated Shanghai Sixth People's Hospital, Shanghai, China.
authors.forename: Congfeng
authors.initials: C
authors.lastname: Luo
authors.affiliation: Department of Geriatric Orthopedics, Shanghai JiaoTong University Affiliated Shanghai Sixth People's Hospital, Shanghai, China.
authors.forename: Chengfang
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Orthopedic Trauma, Shanghai JiaoTong University Affiliated Shanghai Sixth People's Hospital, Shanghai, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Orthopedic Trauma, Shanghai JiaoTong University Affiliated Shanghai Sixth People's Hospital, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhan
mesh_terms: D005593:Fracture Fixation, Internal; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D065466:Lysholm Knee Score; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D064232:Visual Analog Scale