Posterior Column Fractures of the Tibial Plateau

Description

In a presentation focused on surgical strategies regarding posterior column fractures of the tibial plateau, Ashok Gavaskar addresses various key aspects of these injuries. Starting with the classification, he outlines the rarity of isolated posterior column fractures, often seen as part of multi-column injuries, and details the mechanism of these shear injuries which typically occur in a flexed knee position. Gavaskar emphasizes the importance of understanding the fracture patterns which can vary from isolated lesions to more complex cases involving dislocation.



He discusses treatment modalities, highlighting that while some fractures can be approached from an anterior direction using indirect techniques, others require direct manipulation for proper reduction and stabilization. Specific surgical approaches, including a prone Lobenhoffer approach and its advantages for direct access, are contrasted with the supine position, which may be preferred in certain cases due to articular access needs.



Gavaskar also explains that the choice of surgical technique heavily relies on the fracture pattern and the need for comprehensive anatomical reduction. Combining clinical examples, he presents illustrations of various fractures and surgical outcomes, advocating for careful planning based on preoperative imaging. Ultimately, he concludes that managing posterior column fractures necessitates a thoughtful approach, with recommendations for specific indications based on observed fracture complexities, aiming for targeted and effective surgical interventions.

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