{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T16:47:13Z","timestamp":1773161233458,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The clinical effect of the three-incision combined approach for complex fracture of tibial plateau involving the posterior tibial plateau was discussed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed for 13 cases receiving surgery for complex fracture of tibial plateau from July 2015 to June 2019. They received surgery via the three-incision combined approach, and regular postoperative reexamination was performed at the outpatient clinic. During the last follow-up, Hospital for Special Surgery (HSS) Knee Scoring System was used to assess the knee joint function; the Lysholm score was used to assess the knee mobility. The anterior, posterior, and rotational stabilities of the knee joint were assessed by the Lachman test and pivot-shift test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no nonunion and delayed union, implant loosening and fracture, or refracture, and neither were there neurological symptoms or restricted mobility in daily life. During the follow-up, none of the cases were found with restriction of knee mobility caused by internal fixation or apparent pain. The HSS score during the last follow-up was 86\u2013100 (average, 90.2\u2009\u00b1\u20096.8), and the excellent and good rate was 100%; the Lysholm score was 86\u2013100 (average, 95.7\u2009\u00b1\u20092.6). All cases were negative for the Lachman test and pivot-shift test. The knee flexion mobility was 100~140\u00b0 (average, 127.2\u00b0\u2009\u00b1\u200911.4\u00b0). Postoperative X-ray indicated anatomical reduction of bone fractures in all cases. Loss of reduction or loosening and fracture of internal fixation was not observed by postoperative regular reexaminations. The posterior tibial slope at 6\u2009months after surgery was 6~16\u00b0 (average, 10.66\u2009\u00b1\u20092.58\u00b0), the varus angle was 84~89\u00b0 (average, 86.52\u2009\u00b1\u20091.46\u00b0), the Rasmussen radiological score was 12~18 (average, 16.12\u2009\u00b1\u20091.35), and the excellent and good rate was 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The three-incision combined approach proved safe and reliable for complex fracture of tibial plateau involving the posterior tibial plateau and is worthy of further popularization.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13018-020-1572-4","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T13:05:34Z","timestamp":1581426334000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["An analysis on the effect of the three-incision combined approach for complex fracture of tibial plateau involving the posterolateral tibial plateau"],"prefix":"10.1186","volume":"15","author":[{"given":"Guqi","family":"Hong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianrun","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"1572_CR1","doi-asserted-by":"crossref","unstructured":"Langford JR, Jacofsky DJ, Haidukewych GJ. Tibial plateau fractures [M]\/\/Scott WN. Isall & Scott Surgery of the knee. 5th. Philadelphia: Churchill Livingstine, 2011: 773\u2013785.","DOI":"10.1016\/B978-1-4377-1503-3.00081-0"},{"key":"1572_CR2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/00003086-198105000-00015","volume":"156","author":"TM Moore","year":"1981","unstructured":"Moore TM. Fracture-dislocation of the knee. Clin Orthop Relat Res. 1981;156:128\u201340.","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"1572_CR3","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1148\/radiology.211.3.r99jn16754","volume":"211","author":"KK Chan","year":"1999","unstructured":"Chan KK, Resnick D, Goodwin D, et al. Posteromedial tibial plateau injury including avulsion fracture of the semimembranous tendon insertion site: ancillary sign of anterior cruciate ligament tear at MR imaging. Radiology. 1999;211(3):754\u20138.","journal-title":"Radiology"},{"issue":"3","key":"1572_CR4","first-page":"201","volume":"11","author":"CF Luo","year":"2009","unstructured":"Luo CF, Hu CF, Gao H, et al. Three-column classification for tibial plateau fractures. Chin J Orthop Trauma. 2009;11(3):201\u20135.","journal-title":"Chin J Orthop Trauma"},{"issue":"3","key":"1572_CR5","first-page":"254","volume":"32","author":"Y Zhu","year":"2012","unstructured":"Zhu Y, Luo CF, Yang G, et al. Three-column classification for fracture of tibial plateau and the related reliability assessment. Chin J Orthop. 2012;32(3):254\u20139.","journal-title":"Chin J Orthop"},{"issue":"2","key":"1572_CR6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1097\/00005131-200502000-00001","volume":"19","author":"DA Carlson","year":"2005","unstructured":"Carlson DA. Posterior bicondylar tibial plateau fractures. J Orthop Trauma. 2005;19(2):73\u20138.","journal-title":"J Orthop Trauma"},{"issue":"1","key":"1572_CR7","first-page":"6","volume":"9","author":"CF Luo","year":"2007","unstructured":"Luo CF, Jiang R, Zhong B, et al. Open reduction and internal fixation with buttress plating via a posterior approach for posterior shearing fractures of tibial plateau. Chin J Orthop Trauma. 2007;9(1):6\u20139.","journal-title":"Chin J Orthop Trauma"},{"issue":"9","key":"1572_CR8","first-page":"935","volume":"33","author":"HW Chen","year":"2013","unstructured":"Chen HW, Zhang GF, Pan J, et al. Locking compression plate fixation through a modified anterolateral approach for posterolateral tibial plateau fractures. Chin J Orthop. 2013;33(9):935\u201340.","journal-title":"Chin J Orthop"},{"issue":"8","key":"1572_CR9","first-page":"732","volume":"32","author":"Y Zhuang","year":"2012","unstructured":"Zhuang Y, Wang PF, Zhang K, et al. Treatment of posterolateral tibial plateau fractures via the fibular osteotomy approach. Chin J Orthop. 2012;32(8):732\u20138.","journal-title":"Chin J Orthop"},{"key":"1572_CR10","unstructured":"Wu KJ, Hou SX. Practical fixation technique in Department of orthopedics. Beijing: People's Military Medical Press, 2007. 1280\u20131281."},{"issue":"11","key":"1572_CR11","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.2106\/00004623-197355070-00001","volume":"55","author":"PS Rasmussen","year":"1973","unstructured":"Rasmussen PS. Tibial condylar fractures. Impairment of knee joint stability as an indication for surgical treatment. J Bone Joint Surg Am. 1973;55(11):1331\u201350.","journal-title":"J Bone Joint Surg Am"},{"key":"1572_CR12","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00003086-198911000-00004","volume":"248","author":"JN Insall","year":"1989","unstructured":"Insall JN, Dorr LD, Scott RD, et al. Rationale of the knee society clinical rating system. Clin Orthop Relat Res. 1989;248:13\u20134.","journal-title":"Clin Orthop Relat Res"},{"issue":"10","key":"1572_CR13","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.2106\/00004623-200110000-00001","volume":"83","author":"RG Marx","year":"2001","unstructured":"Marx RG, Jones EC, Allen AA, et al. Reliability, validity, and responsiveness of four knee outcome scales for athletic patients. J Bone Joint Surg Am. 2001;83(10):1459\u201369.","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"1572_CR14","first-page":"709","volume":"34","author":"X Gao","year":"2014","unstructured":"Gao X, Hang L, Zheng Q, et al. CT study on the morphology characteristics of posterolateral tibial plateau fractures. Chin J Orthop. 2014;34(7):709\u201316.","journal-title":"Chin J Orthop"},{"issue":"7","key":"1572_CR15","first-page":"565","volume":"17","author":"J Wang","year":"2015","unstructured":"Wang J, Chun-peng Z, Ting L, et al. Frequencies and morphological characteristics of posteromedial and posterolateral fragments in acute tibial plateau fractures. Chin J Orthop Trauma. 2015;17(7):565\u20139.","journal-title":"Chin J Orthop Trauma."},{"issue":"3","key":"1572_CR16","first-page":"180","volume":"91","author":"C Hong-wei","year":"2011","unstructured":"Hong-wei C, Gang-sheng Z, Wang Z-y, et al. Computed tomographic classification of posterior condylar tibial plateau fractures. Natl Med J China. 2011;91(3):180\u20134.","journal-title":"Natl Med J China"},{"issue":"2","key":"1572_CR17","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s11999-012-2451-z","volume":"471","author":"DW Zeltser","year":"2013","unstructured":"Zeltser DW, Leopold SS. Classifications in brief: Schatzker classification of tibial plateau fractures. Clin Orthop Relat Res. 2013;471(2):371\u20134.","journal-title":"Clin Orthop Relat Res"},{"issue":"9","key":"1572_CR18","first-page":"846","volume":"28","author":"L Yong-shan","year":"2015","unstructured":"Yong-shan L, Dong J, Xiong Y, et al. Treatment and analysis of the early postoperative complications of tibial plateau fractures. China J Orthop Trauma. 2015;28(9):846\u20139.","journal-title":"China J Orthop Trauma"},{"issue":"6","key":"1572_CR19","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.knee.2008.07.004","volume":"15","author":"J Tao","year":"2008","unstructured":"Tao J, Hang DH, Wang QG, et al. The posterolateral shearing tibial plateau fracture: treatment and results via a modified posterolateral approach. Knee. 2008;15(6):473\u20139.","journal-title":"Knee"},{"issue":"18","key":"1572_CR20","first-page":"1151","volume":"36","author":"F Gang","year":"2016","unstructured":"Gang F, Pan Z-j, Zheng Q, et al. Anterolateral approach for tibial plateau fractures involving the posterior column. Chin J Orthop. 2016;36(18):1151\u20139.","journal-title":"Chin J Orthop"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-1572-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13018-020-1572-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-020-1572-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,15]],"date-time":"2022-10-15T07:35:22Z","timestamp":1665819322000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-020-1572-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,11]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1572"],"URL":"https:\/\/doi.org\/10.1186\/s13018-020-1572-4","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,11]]},"assertion":[{"value":"8 October 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 January 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43"}}