Posteromedial Tibial Plateau Fixation

Description

In this surgical technique video led by Dr. Ashok Gavaskar, the process of performing a posteromedial tibial plateau Open Reduction and Internal Fixation (ORIF) is demonstrated through two detailed case studies. The first case involves a young male patient who suffered a bicondylar fracture from a motor vehicle accident. The surgical approach begins with careful exposure of the skin and deep fascia, preservation and retraction of the hamstring tendons, and meticulous mobilization of the soleus complex to access the fracture site. Fracture reduction is achieved through various techniques, including the application of lag screws to hold the fracture securely in place, followed by the positioning of a posteromedial plate to buttress the fracture. Postoperative images confirm successful alignment and gradual healing over six months.



The second case features a more complex posteromedial injury in a 35-year-old male with significant soft tissue damage, highlighting the importance of establishing the articular relationship between multiple fragments and correcting a varus deformity. The technique includes surgical arthroscopy to visualize and aid in the reduction of fragments using k-wires for stabilization. Stability is achieved through the use of medial and anteromedial plating, with postoperative radiographs showing excellent outcomes four months post-surgery. This comprehensive approach emphasizes the importance of technique, careful handling of soft tissues, and effective use of fixation devices to ensure optimal recovery.

Specialties