Bicondylar tibial plateau fractures involving the posteromedial fragment: morphology based fixation

The aim of this study is to describe the morphology of the posteromedial fragment in the setting of bicondylar tibial plateau fractures and to use it as a base for selection of the method of fixation.  Twenty two patients with bicondylar tibial plateau fractures involving the posteromedial fragment were included in this study. Plain X- ray and computed tomogram (CT) were performed in all patients. Thirteen patients were treated by dual plating while nine were treated by single lateral plate. The mean posteromedial fragment height was 39 mm. The cephalad surface area percentage of the posteromedial fragment relative to the entire tibial plateau ranged from 10% to 43%. with an average of  28%. The average knee motion at the final follow up was 110°. Two cases were complicated by implant failure.  Morphological study of the  osteromedial fragment could help in selection of the proper method of fixation