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

Document Type : TECHNICAL NOTE

Authors

1 1 Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. 2 Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Orthopaedic and Trauma Surgery, Fundacion Santa Fe de Bogotá, Universidad de los Andes, Colombia

4 Vali-e-Asr Hospital, Arak University of Medical Sciences, Arak, Iran

Abstract

There is no agreement on the best surgical strategy to manage multicolumnar tibial plateau fracture. The combined 
approach used by many investigators has been found to be an effective method. However, combined approaches call 
for repositioning the patient which lengthens the operation time. The sterility of the field of surgery might be jeopardized 
by repositioning. Intraoperative fluoroscopic imaging is hard to adjust to both parts of the combined positions. To tackle 
these problems without sacrificing the concept of three-column tibial plateau, we have started to use a combined medial 
and lateral approach without repositioning the patients using a modified semi-lithotomy position. 
Level of evidence: V

Keywords

References

1. Tarng Y-W, Lin K-C. A combined prone and supine 
approaches for complex three column tibial plateau 
fracture with posterolateral articular injury. Injury. 
2019;50(10):1756-63.
2. Luo C-F, Sun H, Zhang B, Zeng B-F. Three-column 
fixation for complex tibial plateau fractures. Journal 
of orthopaedic trauma. 2010;24(11):683-92.
3. Lin K-C, Tarng Y-W, Lin G-Y, Yang S-W, Hsu C-J, 
Renn J-H. Prone and direct posterior approach for 
management of posterior column tibial plateau 
fractures. Orthopaedics & Traumatology: Surgery & 
Research. 2015;101(4):477-82.
4. Wang Y, Luo C, Zhu Y, Zhai Q, Zhan Y, Qiu W, et al. 
Updated three-column concept in surgical treatment 
for tibial plateau fractures–a prospective cohort 
study of 287 patients. Injury. 2016;47(7):1488-96.
5. Row ER, Komatsu DE, Watson JT, Jones C, Kottmeier 
S. Staged Prone/Supine Fixation of High-Energy 
Multicolumnar Tibial Plateau Fractures: A 
Multicenter Analysis. Journal of orthopaedic trauma. 
2018;32(4):e117-e22.
6. Meulenkamp B, Martin R, Desy NM, Duffy P, Korley R, 
Puloski S, et al. Incidence, risk factors, and location of 
articular malreductions of the tibial plateau. Journal 
of orthopaedic trauma. 2017;31(3):146-50. 
The Archives of Bone and Joint Surgery
Volume 10, Issue 3
March 2022
Pages 293-296

Files

History

  • Receive Date: 11 December 2020
  • Accept Date: 08 May 2021
  • First Publish Date: 19 May 2021

Share

How to cite

Statistics