Operative treatment of ipsilateral noncontiguous unicondylar tibial plateau and shaft fractures: combining plates and nails.

Unicondylar plateau fractures with ipsilateral noncontiguous tibial shaft fractures are rare injuries; over a 10-year period, we identified only 50 of these combined injuries in our series of 1586 tibial fractures. Modern locking plates and percutaneous techniques have been increasingly indicated for this injury pattern though this technique can compromise optimal fixation of the plateau and/or shaft fractures. For a number of years, we have combined intramedullary nails and plates for the treatment of these fractures with excellent results. With careful attention to some technical points, ipsilateral tibial plateau and shaft fractures can be managed successfully by combining 2 familiar techniques commonly employed for each injury in isolation.