[Tibial plateau fractures : Tips and tricks].

Abstract

Fractures of the tibial head continue to pose a challenge in surgical treatment. The goal is to achieve anatomical repositioning of the joint surface in order to prevent the development of posttraumatic gonarthrosis whenever possible. Sequential imaging techniques, such as computed tomography and magnetic resonance imaging, have become established for identifying the fracture morphology along with associated ligamentous and neurovascular accompanying injuries as well as for determining the treatment regimen, and for planning the surgical intervention. The updated S2k guidelines provide assistance for a structured and standardized approach that can be tailored to the individual patient. Based on the preoperative classification of the fracture the optimal procedure can be chosen. In addition to the timing of treatment, the choice of access also has a decisive impact on the postoperative outcome. Modern implants enable fracture-adapted osteosynthesis, likely resulting in less secondary loss of reduction in the hands of an experienced surgeon. Therefore, the training and further education of future surgeons is of great importance to ensure optimal care for our patients.