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Wheeless' Textbook of Orthopaedics
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Tibial Plateau Frx: Surgical Approaches and Theory



- Discussion:
        - Lateral plateau: Incision:
        - Medial Plateau: Incision:

- Tibial Osteotomy:
    - osteotominizing tibial tubercle to incr exposure can lead to difficulty in certain frx, because tubercle may be only
          component of a Bicondylar Fracture left intact;

- Elevation of Fracture Frag:
    - elevation of frx frag is extremely important part of procedure;
    - the elevation must be done enmasse;
    - the fracture tends to compact the 7.htm">Cancellous Bone around these fragmets and make them a solid unit;
    - keeping this compacted Cancellous Bone together w/ articular surface is very important;
    - graft of cancellous Bone wedged underneath elevated fragment will maintain the elevation during the rest of the reduction;

- Ligament Injury:
    - once anatomic reduction & rigid IF are secured, knee is clinically & radiographically examined for collateral ligament instability.
    - completely avulsed ligament should be repaired.





Original Text by Clifford R. Wheeless, III, MD.