A Modified Semi-Lithotomy Position for Approach to Tibial Plateau Complex Fractures: A Technical Note

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Multicolumnar tibial plateau fractures lack a universally agreed-upon optimal surgical strategy.
• Combined surgical approaches are effective but necessitate patient repositioning, increasing operative time and infection risk.
• Repositioning complicates intraoperative fluoroscopic imaging for combined approaches.

Purpose of the Study:

• To present a novel surgical technique for managing three-column tibial plateau fractures.
• To address the limitations of traditional combined approaches, specifically patient repositioning.

Main Methods:

• A modified semi-lithotomy position was employed.
• A combined medial and lateral approach was performed without repositioning the patient.
• This technique preserves the three-column concept of tibial plateau fracture management.

Main Results:

• The modified approach allows for a combined medial and lateral intervention without patient repositioning.
• This technique potentially reduces operative time and maintains surgical field sterility.
• It facilitates easier intraoperative fluoroscopic imaging adjustment.

Conclusions:

• A combined medial and lateral approach without patient repositioning in a modified semi-lithotomy position is a viable strategy for three-column tibial plateau fractures.
• This technique offers a solution to the challenges posed by traditional repositioning methods.