Department of Orthopaedics, Royal Adelaide Hospital and Discipline of Orthopaedics, University of Adelaide, Adelaide, Australia.
J Orthop Trauma. 2010 Aug;24(8):505-14. doi: 10.1097/BOT.0b013e3181ccba4b.
We describe a posterolateral transfibular neck approach to the proximal tibia. This approach was developed as an alternative to the anterolateral approach to the tibial plateau for the treatment of two fracture subtypes: depressed and split depressed fractures in which the comminution and depression are located in the posterior half of the lateral tibial condyle. These fractures have proved particularly difficult to reduce and adequately internally fix through an anterior or anterolateral approach. The approach described in this article exposes the posterolateral aspect of the tibial plateau between the posterior margin of the iliotibial band and the posterior cruciate ligament. The approach allows lateral buttressing of the lateral tibial plateau and may be combined with a simultaneous posteromedial and/or anteromedial approach to the tibial plateau. Critically, the proximal tibial soft tissue envelope and its blood supply are preserved. To date, we have used this approach either alone or in combination with a posteromedial approach for the successful reduction of tibial plateau fractures in eight patients. No complications related to this approach were documented, including no symptoms related to the common peroneal nerve, and all fractures and fibular neck osteotomies healed uneventfully.
我们描述了一种经腓骨后外侧颈入路用于胫骨近端的方法。这种方法是作为胫骨平台前外侧入路的替代方法发展而来的，用于治疗两种骨折亚型：塌陷和合并塌陷骨折，这些骨折的粉碎和塌陷位于外侧胫骨髁的后半部分。这些骨折通过前侧或前外侧入路特别难以复位和充分内固定。本文中描述的方法暴露了胫骨平台的后外侧部分，位于阔筋膜张肌带的后缘和后十字韧带之间。该入路允许外侧胫骨平台的外侧支撑，并且可以与胫骨平台的同时后内侧和/或前内侧入路相结合。重要的是，保留了胫骨近端软组织包膜及其血供。迄今为止，我们已经单独使用或与后内侧入路联合使用该方法成功地复位了 8 例胫骨平台骨折。没有与该入路相关的并发症，包括与腓总神经无关的症状，所有骨折和腓骨颈截骨均顺利愈合。
