The Intact Meniscal “Bucket-Handle” Technique to Expose Complex Lateral Tibial Plateau Fractures

Abstract

There is no consensus on the optimal surgical approach to treat complex tibial plateau fractures, but careful selection of the appropriate surgical approach with clear access to the joint is crucial for successful anatomic reduction. Several articles have described techniques using a fibular or lateral femoral epicondylar osteotomy for improved visualization. Detachment of the anterior horn could facilitate treatment; however, inadequate reattachment of the anterior horn could hinder the healing process and create residual subluxation of the meniscus. This Technical Note describes a surgical technique to provide clear access to the articular surface for the treatment of complex lateral tibial plateau fractures by releasing the posterior meniscocapsular fibers up to the popliteus tendon and folding the lateral meniscus into the intercondylar notch, which exposes the articular surface.