Tibial Plateau "Joint Line" Minimally Invasive Incision

Tibial plateau fracture  

Emergency surgery  

Small case record  

Starting the procedure

For tibial plateau fractures, I generally use Professor Liao Xiong's radiolucent distractor.  

In this case, it seemed straightforward, so I did not apply the distractor.  

The depressed articular surface was visualized directly.  

The plate was used as a channel for plate insertion, then the impactor was introduced to elevate the depressed fragment, and bone grafting was performed through the channel.  

Under direct visualization, the articular surface appeared congruent.  

K-wires were placed parallel and close to the joint line for temporary fixation.  

The lateral plate was implanted.  

Screw holes were drilled without a drill sleeve, and the proximal locking screws were inserted.  

The depressed fragment was located in the anteromedial portion.  

The plate was deliberately positioned slightly anteriorly.  

The height was still half a hole low.  

Comparison with the contralateral side

The articular surface was flat, with good reduction.  

On the magnified lateral view, there was a small 1-mm step-off.  

Given the presence of the meniscus, this should be of little clinical concern.  

External appearance – heart-shaped suture plus super‑tension relief cosmetic suture.  

Reduction is the fastest and most effective means of swelling control.  

With the minimally invasive incision promoted by Professor Hu, soft tissue complications are unlikely.