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Percutaneous Fixation of the Medial Condyle in Bicondylar Tibial Plateau Fractures: Novel Use of the 3.5-mm Medial Distal Tibia Plate
Am J Orthop. 2008 January;37(1):14-17
Author and Disclosure Information
Rakesh P. Mashru, MD, Amir A. Jahangir, MD, Mark S. Parrella, MD, and Susan P. Harding, MD
Dr. Mashru is Section Head and Chief of Service, Division of Orthopaedic Traumatology, Brandywine Institute of Orthopaedics, Pottstown, Pennsylvania.
Dr. Jahangir is Orthopaedic Surgery Resident, and Dr. Parrella is Orthopaedic Trauma Fellow, Department of Orthopaedic Surgery, University of Tennessee–Campbell Clinic, Memphis, Tennessee.
Dr. Harding is Clinical Associate Professor of Orthopaedic Surgery and Director of Orthopaedic Traumatology, Department of Orthopaedic Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
Internal fixation for fractures involving the medial tibial plateau is a controversial topic. Surgical options include buttress plating with antiglide plate, T-shaped proximal tibia plates, external fixation, and isolated screw fixation. Operative management is often complicated by soft-tissue concerns. In this article, we describe a percutaneous surgical technique in which a 3.5-mm medial distal tibia plate, originally designed for distal tibial shaft or pilon fractures, is used in osteosynthesis of the medial tibial plateau. Use of this implant reduces soft-tissue dissection and thereby decreases risk for soft-tissue infection or slough while preventing medial column collapse and varus deformity of the knee. Orthopedic surgeons should consider this novel hardware application as an option for osteosynthesis in certain bicondylar tibial plateau fractures.