Abstract:

Abstract: Objective To observe the clinical effects of double support plate via posteromedial approach in the treat⁃
ment of tibial plateau fracture of posterior column. Methods A total of 21 cases of tibial plateau fracture in closed posterior
column with an average age of 34.6 (range, 21 to 56) years old were treated using double support plate through posteromedial
approach from January in 2010 to January in 2013（16 males and 5 females） . Among all, 4 cases were combined with lateral
column fracture and 17 cases were three column fracture. Wound healings were observed after operation. X-ray examina⁃
tions were performed at 2 weeks, 3 months, 4 months, 6 months and 12 months after operation as well as at last follow up.
The averaged healing time was calculated. Changes of tibial plateau angle and posterior slope angle were compared between
time points at 2 weeks after operation and at last follow up. Rasmussen knee score criteria was employed to assess knee joint
recovery. Results The mean follow-up was (18.2±1.8) months. No infection was reported. The average fracture healing
time was 3.8（3.8±0.6）months. There was no significant difference between tibia plateau angle and posterior slope angle be⁃
tween time points at 2 weeks after operation and at last follow-up (P < 0.05). According to Rasmussen knee score criteria at
last follow-up, 13 cases were graded as excellent, 6 cases as good, and 2 case as fair, with an excellent and good rate of
90.5%. Conclusion With posteromedial approach, the fractures of medial column, posteromedial and posterolateral of pos⁃
terial column can be exposed well. Using double support plates to fix posteromedial and posterolateral of posterior column
fracture can effectively prevent loss of reduction and the function of knee recovered well postoperatively.

Key words: tibia fractures, fracture fixation, internal, plate fixation, posterior approach, knee function