J Korean Fract Soc.  1997 Jan;10(1):53-58.

Meniscal Incision to Approach for Lateral Tibial Plateau Fractures

• Choi MG
• Lee KH
• Chung CH
• Kim HM
• Song HJ

Abstract

Exposure to the posterolateral comer of the tibial condyle was difficult due to narrow joint space and meniscus. From 1995. 1. to 1996. 4., the authors operatively reduced and internally fixed 9 cases of lateral tibial plateau fractures using lateral meniscal incision with minimal detatchment and retraction to improve visualization posterior aspect of articular cartilage Eight of the 9 cases were studied with three dimentional computerised tomogram and 1 case with roentgenographic tomogram to evaluate the shape, site and degree of comminution of the fracture fragments. ROM exercise was started at 4 weeks postopratively, manipulation under anesthesia were done in 3 cases at 12 weeks postoperatively. The follow up period was 13 months(from 8M to 1yr 11M). The results were obtained as follows, 1. Seven cases were split depression type, one was pure depression type and one was bicondylar type. 2. Articular depression were posterolateral aspect in 8 cases, and lateral aspect in one case. The degree of depression was average 15mm(range from 6mm to 22mm). 3. Six of the 9 cases had peripheral tear of the lateral meniscus. 4. Second look arthroscopy shows that the incision site of the meniscus were thinned but completely healed in 3 cases. 5. The ROM of the knee joint were 0 - over 135 in seven cases, 0 - 90 in one case, 30 - 60 in one case. This meniscal incision approach was one of the effective methods that provides exposure of the entire articula surface of the lateral tibial condyle easily to allow accureate eduction.

Keyword

Tibia; Lateral Plateau Fracture; Meniscal Incisioin

MeSH Terms

Anesthesia
Arthroscopy
Cartilage, Articular
Depression
Follow-Up Studies
Joints
Knee Joint
Menisci, Tibial
Tibia