INJURED MORPHOLOGY AND SELECT THE CORRESPONDING APPROACH OF POSTERIOR TIBIAL PLATEAU FRACTURES ON COMPUTED TOMOGRAPHY WITH THREE-DIMENSIONAL RECONSTRUCTION

Abstract

Background: Posterior tibial plateau fractures occur when a fall causes the femoral condyle to impact the knee joint while it is in a bent position. This fracture type is not typical among accident cases and normally is relative to high-energy trauma. A computed tomography with a threedimensional knee joint can accurately establish the knee joint performance to evaluate and diagnose articular surface, type of fractures and surgical planning. Objectives: To examine the morphology of posterior tibial plateau fractures using 3D CT scans. To select and determine the appropriate surgical approach for each type of fracture. Materials and methods: This study included 25 cases of posterior tibial plateau fractures, all of which were treated using three-dimensional CT scans at Can Tho University of Medicine and Pharmacy Hospital and Can Tho Central General Hospital from June 2022 to April 2024. Results: Samples in the study comprised 25 patients, out of whom male respondents were 40%, and female respondents were 60%. The average age was 39.84 ± 14.37 with the highest proportion being the age group 16-40 years old (48%). Isolated fractures of the posterolateral column accounted for 4%, isolated fractures of the posteromedial column for 8%, fractures involving the posteromedial and medial columns for 24%, and posterolateral and lateral column fractures for 16%. The most complex fractures, involving all three columns, accounted for the highest rate of 48%. Most patients underwent surgery in the supine position (92%) for the anterolateral, anteromedial, and posteromedial approach, with 2 patients in the prone position for the reverse L-shaped approach. Our choice of surgical approach is relatively consistent with international studies. Conclusions: The research provides many morphological tibial plateau fractures with 3D CT scans to support classifying the posterior tibial plateau fractures and assists the surgeon in selecting the most suitable surgical approach and optimizing bone fixation techniques tailored to each specific fracture type.

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