{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:41:21Z","timestamp":1777902081659,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The Basic and Clinical Collaborative Research Promotion Initiative of the Third Affiliated Hospital of Anhui Medical University","award":["2023sfy017"],"award-info":[{"award-number":["2023sfy017"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Schatzker IV-C tibial plateau fractures pose a significant challenge for adequate visualization and reduction of the lateral articular surface through a solitary posteromedial (PM) approach. This study aimed to evaluate the effectiveness of an adjunctive lateral patellar ligament (LPL) approach in enhancing articular exposure, assessed through cadaveric modeling and a clinical case series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cadaveric study, eight preserved knee specimens were dissected using a combined PM and LPL approach. The exposed articular area was quantitatively measured using calibrated digital imaging and ImageJ software before and after the LPL approach was established. Clinically, a case series of 10 patients with Schatzker IV-C fractures underwent open reduction and internal fixation via the combined approach between October 2021 and December 2023. Outcome measures included intraoperative exposure, 12-month postoperative Knee Society Score (KSS), and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The addition of the LPL approach resulted in a 96% increase in the mean exposed articular area (from 8.4\u202fcm\u00b2 to 16.5\u202fcm\u00b2;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u202f&lt;\u202f.001) in the cadaveric specimens. All clinical fractures achieved satisfactory reduction and healing. At the 12-month follow-up, the mean KSS was 85.3 (range: 78\u201388), with no cases of infection, wound complications, or delayed union observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The lateral patellar ligament approach significantly improves the surgical exposure of the lateral tibial plateau in Schatzker IV-C fractures when combined with the standard posteromedial approach. This technique facilitates anatomical reduction and meniscal management, contributing to favorable short-term functional outcomes with a low complication rate. It represents a valuable auxiliary option for these complex fractures, particularly in cases involving lateral meniscal impaction or plateau widening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504251392607","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T15:17:29Z","timestamp":1762269449000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced articular exposure using a lateral patellar ligament approach in Schatzker IV-C tibial plateau fractures: A cadaveric and clinical case series"],"prefix":"10.1177","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4984-7755","authenticated-orcid":false,"given":"Run","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University (The Fifth Clinical Medical College of Anhui Medical University), Anhui, 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