Percutaneous fixation of the medial condyle in bicondylar tibial plateau fractures: novel use of the 3.5-mm medial distal tibia plate.

Internal fixation for fractures involving the medial tibial plateau is a controversial topic. Surgical options include buttress plating with antiglide plate, T-shaped proximal tibia plates, external fixation, and isolated screw fixation. Operative management is often complicated by soft-tissue concerns. In this article, we describe a percutaneous surgical technique in which a 3.5-mm medial distal tibia plate, originally designed for distal tibial shaft or pilon fractures, is used in osteosynthesis of the medial tibial plateau. Use of this implant reduces soft-tissue dissection and thereby decreases risk for soft-tissue infection or slough while preventing medial column collapse and varus deformity of the knee. Orthopedic surgeons should consider this novel hardware application as an option for osteosynthesis in certain bicondylar tibial plateau fractures.