Anterior displacement of an avulsed posterio-latero-central tibial plateau fracture repaired with Herbert screws

INTRODUCTION: Tibial plateau fractures are very complex articular fractures with a rare incidence of approximately 10.3%. These fractures may constitute a severe injury to the knee joint and other complications. PRESENTATION OF CASE: A 23- year-old male injured his right knee after a crush accident and was diagnosed with a posterio-latero-central (PLC) sheared fracture of the tibial plateau without an injury to knee ligaments. CT with a reconstruction of the right knee showed that the fracture was accompanied by a free fragment inserted into the anterior compartment of the knee. The free fragment was repositioned to its native location and was fixed with three Herbert screws. Also, we found a peripheral avulsion of the posterio-lateral (PL) portion of the lateral meniscus from the capsular attachment, which was repaired with vicryl absorbable suture. An above knee cast was put in 15-degree flexion for three weeks followed by a restoration of knee movements and weight-bearing after ten weeks of surgery. The patient had a full range of motions and no signs of joint laxity after one year of operation. DISCUSSION CONCLUSION: This study revealed that the surgical repair allowed a quick return to movement for a PLC sheared fracture of the tibial plateau and can be fixed sufficiently to achieve excellent postoperative recovery.