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Association with posteromedial corner of the knee injury
9%
95/1032
Association with anterior tibial artery injury
8%
85/1032
Possible need for dual plate fixation
80%
826/1032
Possible need for single extensile anterior approach to the knee
1%
7/1032
Increased risk of deep venous thrombosis
13/1032
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Figures A and B show a bicondylar tibial plateau fracture with a large posteromedial fracture piece. This has clinical importance, as currently available plate/screw constructs often have poor fixation of this fracture segment, and this pattern often requires a second, posteromedial, approach and placement of a second plate/screw construct. The referenced article by Barei et al notes a prevalence of posteromedial fracture pieces of nearly 33% of all bicondylar tibial plateau fractures. They also recommend supplementary or alternative fixation techniques when this pattern is recognized. The referenced article by Higgins et al notes a 59% incidence of this fracture pattern (consisting of nearly 25% of the total joint surface) in bicondylar tibial plateau fractures, and recommends appropriate fixation to combat the vertical shear instability through a separate approach. The last referenced study by Higgings et al notes a significantly increased rate of late fracture displacement in a biomechanical model with a single lateral locking plate as compared to a dual plate construct.
2.8
(42)
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