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Patellar Tendon Z-plasty Approach for Comminuted Tibial Plateau Fractures
Pavlos Mouratidis1, Georgios E Prelorentzos1, Aristeidis Koutsopoulos1
14th Department of Orthopaedics, KAT Attica General Hospital, Athens, GRC.
Cureus
|December 22, 2025
Summary
The patellar tendon Z-plasty approach offers a safe surgical option for comminuted tibial plateau fractures. This technique provides excellent visibility for anatomic reduction and yields favorable patient outcomes.
Area of Science:
- Orthopedic Surgery
- Traumatology
Background:
- Comminuted tibial plateau fractures, especially those involving the intercondylar area or posterior condyles, present significant surgical challenges.
- Achieving anatomic reduction and optimal functional outcomes requires effective surgical approaches.
Purpose of the Study:
- To describe the surgical technique of patellar tendon Z-plasty for comminuted tibial plateau fractures.
- To evaluate the functional and radiological outcomes of this approach in patients with complex fractures.
Main Methods:
- A retrograde analysis of nine patients (average age 42) with comminuted tibial plateau fractures treated between 2011 and 2025.
- Surgical intervention involved a midline incision with patellar tendon Z-plasty for improved visualization and reduction.
Main Results:
- Average follow-up was 5.3 years, with no extensor mechanism complications reported.
- Patients achieved a normal range of motion (0°-140°), with one case of mild flexion contracture due to osteoarthritis.
- Knee function was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS).
Conclusions:
- Patellar tendon Z-plasty is a safe and effective surgical approach for comminuted tibial plateau fractures.
- The technique facilitates easier anatomic reduction under direct vision via a single anterior incision.
- Excellent postoperative results and functional recovery were observed in the study cohort.
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