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Anatomic lateral locking plate
1%
37/2711
Posteromedial and lateral plates
78%
2125/2711
Anatomic medial locking plate
6%
170/2711
Conversion of the spanning external fixator to a hinged external fixator
0%
9/2711
Posterior buttress plate
13%
358/2711
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Figures A and B show a bicondylar tibial plateau fracture, with a typical appearing lateral fracture line and a posteromedial fracture line. The posteromedial sheared fracture piece is difficult, and/or sometimes impossible, to achieve appropriate stable fixation with a single lateral locking plate, as there will be limited screw purchase and fixation into the posteromedial fragment. The referenced article by Georgiadis notes that a dual incision approach is safe and is associated with improved outcomes over their historical comparisons. They describe the dual incisions and approaches in length, and review risks/issues with each approach. The other referenced study by Bhattacharyya et al notes that these fractures have a typical appearance of the posteromedial fracture piece and that articular reduction quality is correlated with short-term results. They recommended buttress-type fixation of these fracture pieces.
2.3
(51)
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