Combined anterior and posterior approaches for complex tibial plateau fractures.

We report the use of combined anterior and posterior approaches for the reduction and fixation of complex tibial plateau fractures involving a large split posteromedial fragment. In four patients, we used a posterior plate to fix the posteromedial fragment. All fractures united in good position with no significant complications, and all patients had a good range of knee movement. This technique should be considered for complex fractures in which there is a substantial posteromedial fragment (split) component.