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February 19, 2016
Contributors: Stephen Kottmeier, MD; Elliot Row, MD; J Tracy Watson, MD; Clifford B Jones, MD, FACS
A critical assessment of radiographic and clinical outcomes, when managing complex articular fragments of the proximal tibia, demonstrates several aspects worthy of re-evaluation and potential modification.
These include: 1) Refined understanding of fracture pathoanatomy and classification;
2) Surgical access (operative exposure) and timing;
3) Preferential fixation constructs; and
4) Implant design modification. The following presentation highlights the attributes and limitations of contemporary classification schemes and the role posterior access in the prone position may offer in select scenarios.
The following are discussed:
1) Axial classification schemes;
2) Posteromedial (Iobenhoffer) surgical exposure - technique;
3) Indications and case examples of retrocondylar access and fixation; and
4) The author's clinical experience and outcomes.