A modified Frosch approach for posterior tibial plateau fractures: Technical note and case series.

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Abstract

[Indexed for MEDLINE] 7. BMC Musculoskelet Disord. 2025 Jan 14;26(1):47. doi: 10.1186/s12891-025-08321-8. Treatment of posterolateral tibial plateau fractures through the articular line approach. Hu J(1)(2), Zhang H(3)(4). Author information: (1)Department of Orthopaedic, The First Affiliated Hospital of Hebei Medical University, Hebei, 050000, China. hujinxi215@163.com. (2)Department of Orthopedics, Yueyang People's Hospital, Hunan, 414000, China. hujinxi215@163.com. (3)Department of Orthopedics, Lishui Central Hospital, Zhejiang, 323000, China. (4)Department of Orthopedics, Yueyang People's Hospital, Hunan, 414000, China. BACKGROUND: Posterolateral tibial plateau fractures pose significant challenges for orthopedic surgeons due to the anatomical risks associated with the posterolateral approach. Despite numerous surgical techniques available, there lacks a consensus on the optimal approach. METHODS: Articular line incision approach was employed on 12 patients suffering from posterolateral tibial plateau fractures. Preoperative CT scans were utilized to assess the fractures, followed by an articular line incision to expose and fix the fractures with a 3.5 mm low-profile lateral locking compression plate. The surgical outcomes were evaluated through postoperative recovery metrics including pain levels, knee joint stability, and recovery time. RESULTS: All patients achieved articular surface reduction and stable fixation without complications, loss of reduction, or infection. Postoperative assessments showed normal knee extension, with patients returning to pre-injury work levels. The average range of motion (ROM) of the knee joint was 123.3°, and the average Hospital for Special Surgery (HSS) score was 96.4, indicating successful recovery outcomes. CONCLUSION: The articular line incision approach for posterolateral tibial plateau fractures provides a viable alternative to traditional methods. It offers the benefits of reduced trauma, shortened recovery times, and minimized risk of infection, making it a recommendable technique for such fractures. TRIAL REGISTRATION: Not applicable. © 2025. The Author(s). DOI: 10.1186/s12891-025-08321-8 PMCID: PMC11734538