Posterolateral tibia plateau fractures: pros and cons of different surgical approaches

Posterolateral tibial plateau fractures are complex injuries requiring a thorough understanding of the anatomical structures involved, including the popliteus tendon, lateral collateral ligament and posterior horn of the lateral meniscus. Standard anterolateral or midline approaches provide limited access to the posterolateral corner, often necessitating specific surgical techniques to achieve optimal fracture reduction and joint stability. This review explores the main surgical approaches used for these fractures outlining their indications, advantages and limitations. Each section provides a step-by-step guide for an effective surgical technique, based on experience from a high-volume trauma center, to optimize exposure, reduction and fixation. Understanding the biomechanical and anatomical aspects of these fractures is crucial for selecting the most appropriate surgical strategy, minimizing complications and improving patient outcomes.