Open reduction and fixation of medial Moore type II fractures of the tibial plateau by a direct dorsal approach

INTRODUCTION: Moore type II Entire Condyle fractures of the tibia plateau represent a rare and highly unstable fracture pattern that usually results from high impact traumas. Specific recommendations regarding the surgical treatment of these fractures are sparse. We present a series of Moore type II fractures treated by open reduction and internal fixation through a direct dorsal approach. PATIENTS AND METHODS: Five patients (3 females, 2 males) with Entire Condyle fractures were retrospectively analyzed after a mean follow-up period of 39 months (range 12-61 months). Patient mean age at the time of operation was 36 years (range 26-43 years). Follow-up included clinical and radiological examination. Furthermore, all patient finished a SF36 and Lysholm knee score questionnaire. RESULTS: Average range of motion was 127/0/1 degrees with all patients reaching full extension at the time of last follow up. Patients reached a mean Lysholm score of 81.2 points (range 61-100 points) and an average SF36 of 82.36 points (range 53.75-98.88 points). One patient sustained deep wound infection after elective implant removal 1 year after the initial surgery. Overall all patients were highly satisfied with the postoperative result. CONCLUSION: The direct dorsal approach to the tibial plateau represents an adequate method to enable direct fracture exposure, open reduction, and internal fixation in posterior shearing medial Entire Condyle fractures and is especially valuable when also the dorso-lateral plateau is depressed.