Treatment of tibial plateau fractures by modified posterior medial approach

Abstract

Abstract Purpose To report the effect of posterior medial approach preserving pes anserinus in the treatment of tibial plateau fracture. Method Patients who underwent surgery in a large hospital due to tibial plateau fractures from December 2013 to January 2021 were retrospectively analyzed.These patients underwent a posteromedial approach preserving the pes anserinus and a traditional posteromedial approach.The general information, fracture classification, preoperative and postoperative conditions of the patients were recorded and compared. HSS score and VAS score were used to evaluate knee function and pain respectively. Result All patients were followed for more than 1 year.In general, there were no statistically significant differences to the baseline demographic factors between the two groups.The patients in the observation group had longer operation time, more intraoperative bleeding and intraoperative fluoroscopy times, the difference was statistically significant.The observation group had lower VAS scores, either on day 1, day 3 or day 14 after surgery.The observation group had a better HSS score 3 months after operation, and the difference was statistically significant. However, there was no significant difference in HSS score between the two groups one year after operation.Similarly, the patients in the observation group had better knee range of motion 3 months after operation, and the difference was statistically significant. However, there was no significant difference in HSS score between the two groups one year after operation. Conclusion In conclusion, compared with the traditional posteromedial approach, the modified posteromedial approach with pes anserinu preserved can significantly reduce soft tissue injury in the operative area, relieve early postoperative pain, and improve early knee range of motion.