Special Focus Section 3
Foreword
Tibial Plateau Fractures
Michael J. Gardner, MD1 Andrew H. Schmidt, MD2
1 Department of Orthopaedic Surgery, Washington University School
of Medicine, Saint Louis, Missouri
2 Department of Orthopedic Surgery, Hennepin County Medical
Center, Minneapolis, Minnesota
J Knee Surg 2014;27:3–4.
Tibial plateau fractures come in many varieties, but in most
instances, present management challenges on many levels.
The majority of tibial plateau fractures are treated surgically,
given their intraarticular or periarticular nature and their
typical magnitude of displacement and instability. The first
treatment dilemma is the decision regarding when to oper-
ate. Not too long ago, early open treatment of high-energy
bicondylar tibial fractures was clearly recognized as a high-
risk situation. Focus was appropriately shifted to the soft
tissue component of these injuries. In this issue, Dr. Borrelli
discusses some pertinent anatomical features of the proximal
tibia, as well as indications and techniques for provisional
spanning external fixation. Along similar lines, but focusing
more globally on the prevention and treatment of complica-
tions associated with tibial plateau fractures, Drs. Choo and
Morshed provide an extremely insightful and comprehensive
overview of complications.
Just as fixation strategies and implants have evolved over
the last decade, so have surgical approaches to the proximal
tibia. Depending on the specific fracture pattern, one or
several of half a dozen surgical approaches may be appropri-
ate. Drs. Kandemir and Maclean present step-by-step de-
scriptions of common approaches to the tibial plateau,
Address for correspondence
Michael J. Gardner, MD,
Department of Orthopaedic
Surgery, Washington University
School of Medicine, 660 South
Euclid Avenue, Campus Box 8233,
Saint Louis, MO 63110
(e-mail: gardnerm@wudosis.
wustl.edu).
including posterolateral, posteromedial, and direct posterior
approaches. The descriptive text is accompanied by many
illustrative photographs.
Despite the frequent focus on specific implants, it must be
remembered that the reduction is arguably the most impor-
tant aspect of surgical treatment. As such, Mauffrey et al
Downloaded by: WEST VIRGINIA UNIVERSITY. Copyrighted material.
present a novel cutting-edge reduction technique using in-
flatable balloon tamps that is currently a hot topic. Excellent
technique descriptions and examples are included, as well as
the specific ideal indications for this technique.
Finally, given the recent descriptive, biomechanical, and
clinical literature revolving around the medial component of
bicondylar tibial plateau fractures, Dr. Cherney and myself
have dedicated a manuscript to this topic. Several common
variations of the medial fracture component are discussed, as
well ideal treatments for different patterns.
This issue of the Journal of Knee Surgery features some of
the world’s experts in tibial plateau fracture treatment. These
authors have devoted their careers to studying the natural
history of these fractures and pioneering new techniques and
surgical approaches to maximize patient outcomes. We hope
you enjoy this issue, and find these papers useful for your
practice.
Copyright © 2014 by Thieme Medical DOI http://dx.doi.org/
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Tel: +1(212) 584-4662.