The posterolateral shearing tibial plateau fracture: treatment and results via a modified posterolateral approach.

The posterolateral shearing tibial plateau fracture is relatively uncommon and few studies have concentrated on it so far. The purpose of this study was to review the results of surgical treatment of this kind of fracture using a modified posterolateral approach. The clinical results of a case series of 11 patients, collected prospectively, were presented here. At final follow-up 10 out of 11 (91%) patients had satisfactory reduction of the articular surface and all had acceptable alignment. There was neither any loss in reduction or alignment at one year postoperation, with a mean HSS score of 93 (s.d. 3.67, range 84 to 97), nor superficial or deep infections, except that one case had a sanguinous effusion for more than one week postoperatively. It was concluded that the modified posterolateral approach could help to expand the surgical options for an optimal treatment of this kind of fracture, and plating of posterolateral shearing fractures would result in restoration and maintenance of alignment.