Abstract
Introduction In recent years, the use of horizontal plates has been described to achieve fixation
of fractures that compromise the articular ridge of the tibial plateau; these plates
are known as “rim plates.” Most publications report their use in the posterior and
posterolateral columns of the tibial plateau, and to date there are few reports of
its use for the fixation of the anteromedial column and none for the posteromedial
column. The objective of the present article is to report two clinical cases of comminuted
fractures of the medial tibial plateau, showing their treatment with the use of medial
rim plates.
Clinical Cases The first case presented with an anteromedial and posteromedial tibial plateau fracture,
and the second, a posteromedial fracture. In both cases, reduction was achieved through
a posteromedial approach, and the fixation was performed with a 2.7-mm locked rim
plate. The reduction strategy and postoperative management were detailed in each case.
Results Both patients achieved bone consolidation during the 14th and 18th weeks after the
definitive osteosynthesis, without presenting loss of reduction. Both patients achieved
full range of joint motion (0°–125°) and returned to work after four and six months
respectively.
Conclusions These plates offer a good treatment option for comminuted fractures of the rim of
the tibial plateau, for both the anteromedial and posteromedial columns. Despite the
absence of large series of patients with the use of medial rim plates, the results
of the two cases herein presented enables us to propose it as a useful tool when dealing
with fractures of the medial rim of the tibial plateau.
Level of evidence V.
Keywords
tibial plateau fracture - internal fracture fixation - posteromedial approach - horizontal
rafting plate - rim plate
