OBJECTIVETo analyze and compare the efficacy of surgical approaches and fixations of anterolateral approach, lateral approach and posterolateral approach in treating posterolateral tibial plateau fracture.

METHODSA retrospective study of 44 cases from May 2010 to July 2014 were enrolled, of which there were 21 males and 23 females, and the mean age was 42.5 years old (ranged, 26 to 61 years). All the cases were divided into 3 groups according to the surgical approach, group A was anterolateral approach (19 cases), group B was lateral approach (15 cases), group C was posterolateral approach (10 cases). Operative time and bleeding volum were compared and the knee function was observed.

RESULTSThe mean operative time of group A was (91.3±10.4) min, and the bleeding volum of which was (175.3±20.3) ml. The mean operative time of group B was(86.6±9.2) min, and the bleeding volum of which was(155.8±18.2) ml. The mean operative time of group C was (109.5±10.8) min, and the bleeding volum of which was(235.9±29.1) ml. There were significant differences in operative time and bleeding volum between group C and the other two groups(<0.05). The mean follow-up time was 14.9 months (ranged, 10 to 35 months), and the HSS score of last follow-up was 89.6±7.5 (group A), 90.2±6.4(group B), 88.9±5.1 (group C). There were no significant differences in groups(>0.05).

CONCLUSIONSThe operative time of posterolateral approach was longer than anterolateral approach or lateral approach, as well as the bleeding volum which was higher in posterolateral approach, while no significant difference of the knee function was observed in these 3 different approaches.