Surgical Approaches to Posterolateral Tibial Plateau Fractures

Matthew R. Garner, Stephen J. Warner, Dean G. Lorich

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Tibial plateau fractures involving the posterolateral articular surface present a unique challenge to treating surgeons due to the complex anatomy of the region. The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force. Further, injury to the soft tissue envelope may prevent use of the optimal surgical incision. For these reasons, a thorough understanding of the anatomy and available approaches is essential when treating these fractures. Approach selection should be based on fracture pattern, the surrounding soft tissue envelope, and the patient's clinical conditions; concomitant injuries and overall health status must be accounted for. In this article, we highlight five surgical approaches that can be utilized to improve visualization and access to the posterolateral tibial plateau. These include three separate osteotomies performed through an anterolateral approach: lateral femoral epicondyle osteotomy, fibular head resection osteotomy, and a novel digastric fibular osteotomy. In addition, we will discuss a posterolateral approach and a direct posterior approach.

Original languageEnglish (US)
Pages (from-to)12-20
Number of pages9
JournalThe journal of knee surgery
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2016

Fingerprint

Tibial Fractures
Osteotomy
Joints
Anatomy
Soft Tissue Injuries
Peroneal Nerve
Thigh
Health Status
Head
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Garner, Matthew R. ; Warner, Stephen J. ; Lorich, Dean G. / Surgical Approaches to Posterolateral Tibial Plateau Fractures. In: The journal of knee surgery. 2016 ; Vol. 29, No. 1. pp. 12-20.
@article{6e6b1c9f790a41bcadc10283b34a59da,
title = "Surgical Approaches to Posterolateral Tibial Plateau Fractures",
abstract = "Tibial plateau fractures involving the posterolateral articular surface present a unique challenge to treating surgeons due to the complex anatomy of the region. The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force. Further, injury to the soft tissue envelope may prevent use of the optimal surgical incision. For these reasons, a thorough understanding of the anatomy and available approaches is essential when treating these fractures. Approach selection should be based on fracture pattern, the surrounding soft tissue envelope, and the patient's clinical conditions; concomitant injuries and overall health status must be accounted for. In this article, we highlight five surgical approaches that can be utilized to improve visualization and access to the posterolateral tibial plateau. These include three separate osteotomies performed through an anterolateral approach: lateral femoral epicondyle osteotomy, fibular head resection osteotomy, and a novel digastric fibular osteotomy. In addition, we will discuss a posterolateral approach and a direct posterior approach.",
author = "Garner, {Matthew R.} and Warner, {Stephen J.} and Lorich, {Dean G.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1055/s-0035-1564731",
language = "English (US)",
volume = "29",
pages = "12--20",
journal = "Journal of Knee Surgery",
issn = "1538-8506",
publisher = "Thieme Medical Publishers",
number = "1",

}

Surgical Approaches to Posterolateral Tibial Plateau Fractures. / Garner, Matthew R.; Warner, Stephen J.; Lorich, Dean G.

In: The journal of knee surgery, Vol. 29, No. 1, 01.01.2016, p. 12-20.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Surgical Approaches to Posterolateral Tibial Plateau Fractures

AU - Garner, Matthew R.

AU - Warner, Stephen J.

AU - Lorich, Dean G.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Tibial plateau fractures involving the posterolateral articular surface present a unique challenge to treating surgeons due to the complex anatomy of the region. The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force. Further, injury to the soft tissue envelope may prevent use of the optimal surgical incision. For these reasons, a thorough understanding of the anatomy and available approaches is essential when treating these fractures. Approach selection should be based on fracture pattern, the surrounding soft tissue envelope, and the patient's clinical conditions; concomitant injuries and overall health status must be accounted for. In this article, we highlight five surgical approaches that can be utilized to improve visualization and access to the posterolateral tibial plateau. These include three separate osteotomies performed through an anterolateral approach: lateral femoral epicondyle osteotomy, fibular head resection osteotomy, and a novel digastric fibular osteotomy. In addition, we will discuss a posterolateral approach and a direct posterior approach.

AB - Tibial plateau fractures involving the posterolateral articular surface present a unique challenge to treating surgeons due to the complex anatomy of the region. The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force. Further, injury to the soft tissue envelope may prevent use of the optimal surgical incision. For these reasons, a thorough understanding of the anatomy and available approaches is essential when treating these fractures. Approach selection should be based on fracture pattern, the surrounding soft tissue envelope, and the patient's clinical conditions; concomitant injuries and overall health status must be accounted for. In this article, we highlight five surgical approaches that can be utilized to improve visualization and access to the posterolateral tibial plateau. These include three separate osteotomies performed through an anterolateral approach: lateral femoral epicondyle osteotomy, fibular head resection osteotomy, and a novel digastric fibular osteotomy. In addition, we will discuss a posterolateral approach and a direct posterior approach.

UR - http://www.scopus.com/inward/record.url?scp=84968858562&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84968858562&partnerID=8YFLogxK

U2 - 10.1055/s-0035-1564731

DO - 10.1055/s-0035-1564731

M3 - Review article

C2 - 26480345

AN - SCOPUS:84968858562

VL - 29

SP - 12

EP - 20

JO - Journal of Knee Surgery

JF - Journal of Knee Surgery

SN - 1538-8506

IS - 1

ER -