Modified gastrocnemius splitting anatomic approach to the tibial plateau. Medium-term evaluation.

Injury

Departamanto de Trauma y Reconstrucción Esquelética - Complejo Medico de la Policia Federal Argentina Churruca-Visca, Uspallata 3400, Buenos Aires C1437 JCP, Argentina.

Published: November 2023

Background: Posterior tibial plateau fractures, including avulsion fractures of the posterior cruciate ligament (PCL) insertion, represent a challenge for the orthopedic trauma surgeon. These injuries have gained a new perspective both diagnostically and therapeutically after the regular use of multiplanar computed tomography. In the herein study, we describe the outcome of patients sustaining a tibial plateau fracture with posterior articular involvement treated by open reduction and internal fixation (ORIF) using our modified gastrocnemius splitting anatomic approach.

Methods: This observational retrospective descriptive study was conducted at Complejo Medico de la Policia Federal Argentina Churruca-Visca. All patients were treated by ORIF by our team through our modified gastrocnemius splitting anatomic approach, and followed-up for a minimum of 12 months.

Results: A total of 18 patients sustaining plateau fracture were treated by this approach. Satisfactory tomographic reduction with articular gap and/or step-off <2 mm was achieved in 16. The mean time to the return to activities of daily living was 192.2 days.

Conclusion: The modified gastrocnemius splitting anatomic approach represents a good alternative for the management of tibial plateau fractures involving the posterior quadrants.

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Source
http://dx.doi.org/10.1016/j.injury.2023.111021DOI Listing

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