title: Complications and outcomes of the transfibular approach for posterolateral fractures of the tibial plateau.
abstract: OBJECTIVE
  Evaluate complication rates and functional outcomes of fibular neck osteotomy for posterolateral tibial plateau fractures.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  From January 2013 to October 2014, 11 patients underwent transfibular approach for posterolateral fractures of the tibial plateau and were enrolled in the study. All patients who underwent transfibular approach were invited the return to the hospital for another clinical and imaging evaluation.
  
  
  METHODS
  Transfibular approach (fibular neck osteotomy) with open reduction and internal fixation for posterolateral fractures of the tibial plateau.
  
  
  METHODS
  Complications exclusively related to the transfibular approach: peroneal nerve palsy; knee instability; loss of reduction; nonunion and malunion of fibular osteotomy; and functional outcomes related to knee function.
  
  
  RESULTS
  Two patients failed to follow-up and were excluded from the study. Of the 9 patients included in the study, no patients demonstrated evidence of a peroneal nerve palsy. One patient presented loss of fracture reduction and fixation of the fibular neck osteotomy, requiring revision screw fixation. There were no malunions of the fibular osteotomy. None of the patients demonstrated clinically detectable posterolateral instability of the knee following surgery. American Knee Society Score was good in 7 patients (77.8%), fair in 1 (11.1%), and poor in 1 (11.1%). American Knee Society Score/Function showed 80 points average (60-100, S.D:11).
  
  
  CONCLUSIONS
  The transfibular approach for posterolateral fractures is safe and useful for visualizing posterolateral articular injury. The surgeon must gently protect the peroneal nerve during the entire procedure and fix the osteotomy with long screws to prevent loss of reduction.
  
  
  METHODS
  Therapeutic level IV.
authors.affiliation: Department of the Locomotive Apparatus, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. Electronic address: robinsonestevespires@gmail.com.
authors.forename: Robinson Esteves Santos
authors.initials: RES
authors.lastname: Pires
authors.affiliation: Department of Orthopedics and Traumatology, Miguel Couto Hospital, Rio de Janeiro, RJ, Brazil.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Giordano
authors.affiliation: Department of Orthopedics and Traumatology, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Wajnsztejn
authors.affiliation: Department of Orthopedics and Traumatology, Miguel Couto Hospital, Rio de Janeiro, RJ, Brazil.
authors.forename: Egidio
authors.initials: E
authors.lastname: Oliveira Santana
authors.affiliation: Department of Orthopedics and Traumatology, Fundación Santa Fe de Bogotá, Bogotá, CU, Colombia.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Pesantez
authors.affiliation: Department of Orthopaedic Surgery, University of California, Davis Medical Center, Sacramento, CA, United States.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lee
authors.affiliation: Department of the Locomotive Apparatus, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Marco Antônio Percope
authors.initials: MAP
authors.lastname: de Andrade
mesh_terms: D000328:Adult; D001863:Bone Screws; D001938:Brazil; D005260:Female; D005360:Fibula / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010543:Peroneal Nerve / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Fibular neck osteotomy; Fractures; Fractures of the tibial plateau; Knee fractures; Nonunion; Peroneal nerve palsy; Plate fixation; Tibial plateau; Tibial plateau fractures; Transfibular osteotomy