Anterior approach for posteromedial tibial plateau fractures

Fractures of the posteromedial tibial plateau are rare and their treatment is not well established. Between January 2004 and December 2008, eight patients with fractures of the posteromedial tibia plateau were identified. All patients were treated with fracture reduction using an anterior approach. After a mean follow-up of 21 months, the average range of knee motion was 0-123 degrees of flexion. Seven patients had been injured in motor-scooter accidents, in which the protective front plate of the scooter had hit the knee while it was in the 90 degrees -flexion position. At the final follow-up, 87.5% (7/8) patients had satisfactory reductions of the articular surface, and all patients had acceptable alignments. There were no neural or vascular injuries following surgery, and no superficial or deep infections. The average Hospital for Special Surgery Knee Score was 89. In conclusion, fracture reduction using the anterior approach is associated with fewer complications than the posterior approach, and good functional recovery can be expected.