Combined lateral peripatellar and posteromedial approaches for Schatzker type IV tibial plateau fractures involving posteromedial plane: a prospective study

BACKGROUND: The objective of this study to evaluate prospectively the effectiveness of Schatzker type IV tibial plateau fractures involving posteromedial plane managed by combined lateral peripatellar and posteromedial approaches. METHODS: We analyzed 18 patients with Schatzker type IV tibial plateau fractures involving posteromedial plane. There were 12 males and 6 females with an average of 38.5 years (range, 25–60 years). The mechanism of injury included traffic accident in 15 patients and falling in 3 patients. The injured lower limbs were right in 11 patients and left in 7 patients. The mean time from injury to surgery was 6.78 days (range, 5–9 days). There were 8 patients with meniscus injuries in our study. RESULTS: The mean operation time was 3.41 h (range, 3–4 h). The mean blood loss was 352.78 ml (range, 300–410 ml). All the injured meniscuses were repaired. All patients were followed up, and the average time of follow up was 16.61 months (range, 14–22 months). Bone union was achieved at a mean of 12 weeks (range, 10–14 weeks). The mean degree of knee extension was 1.11° (range, 0–5°), and the mean degree of knee flexion was 120.56° (range, 110–130°). The mean points of KSS were 83 (range, 74–89 points). According to the criteria of KSS, 14 patients had clinical outcomes rated as excellent and 4 patients were rated as good. CONCLUSION: Our results suggested that Combined lateral peripatellar and posteromedial approaches in the treatment of Schatzker type IV tibial plateau fractures involving posteromedial plane acquired satisfying outcomes. It was good for repairing the injured meniscus through our approaches.