Treatment of posterolateral tibial plateau fractures through the articular line approach.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethics approval and consent to participate: This study has been approved by the appropriate ethical review committee and strictly complies with all the provisions of the Declaration of Helsinki. All participants were fully informed of the nature of the study prior to the start of the study and signed informed consent forms. This study was approved by the Medical Ethics Review Committee of Yueyang City People’s Hospital, approval number: No. 2020015. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. 8. J Orthop Trauma. 2024 Jul 1;38(7):e272-e276. doi: 10.1097/BOT.0000000000002812. Intraosseous Shelf Plate Fixation for Depressed Articular Fragments in Tibial Plateau Fractures: A Technical Trick and Case Series. Campbell ST(1), Earhart J(2), Marchand LS(3), Bilodeau RE(4), Barth K(4), Ricci WM(4), Githens MF(5). Author information: (1)Department of Orthopaedic Surgery, University of California Davis Medical Center, Sacramento, CA. (2)Orthopaedic Trauma Service, OrthoIllinois, Rockford, IL. (3)Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT. (4)Hospital for Special Surgery, New York City, NY; and. (5)Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA. Tibial plateau fractures with severely displaced articular injuries and significant deformity to the surrounding metaphyseal bone (including the hyperextension varus bicondylar pattern) can be challenging to stabilize due to resulting large bone voids uncontained by metaphyseal cortex. The purpose of this report was to describe a technique to support the plateau articular surface in these cases and report on outcomes of a small series. This technique uses a small or mini fragment plate, contoured to function as an intraosseous shelf plate, with the "shelf" portion inserted into the bone beneath the articular surface to support it. This technique provides fixed-angle support to the fragment. There are some advantages of this technique compared to structural allograft, large volume ceramic bone void filler, a spine cage, or other trabecular metal object, including the ability to remove the plate later, ability to tension the plate against the depressed articular surface, ability to place screws or other allograft near the implant, wide availability of the implant, and familiarity of orthopaedic trauma surgeons with placing plates and screws to hold reductions. The technique is particularly useful in patterns with uncontained articular depression and a large metaphyseal void. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/BOT.0000000000002812