ABSTRACT
Surgery Report The patient was placed in the dorsal recumbent position and a 4 cm incision was made starting at the medial aspect of the tibial plateau. A second, 2 cm, incision was made 1 cm proximal to the medial maleolus. A 3.2 mm IM pin was normograded from the proximal tibial plateau and seated into the distal tibial metaphysis. After starting placement of this pin, it was removed, the tip was blunted and then reintroduced into the same guide hole and seated. After seating, the pin was marked at the level of the tibial plateau, withdrawn, cut at that mark, and again seated, this time with a counter sink. A 15-hole, 3.5 mm broad, LC-DCP was contoured compliant to radiographs of the contralateral tibia. A periosteal elevator was used to create plate passage subperiosteal from the proximal-to-distal incision. The first and fifteenth screws were placed bicortically, after which fracture reduction was confirmed. Bicortical screws were placed in sequence in screw holes 2, 3 and 14. Unicortical screws were placed in holes 4 and 5. Bone grafting was not performed. The incision was closed routinely. Postoperative radiographs revealed that the third bicortical screw entered the fracture line. This screw, as well as those in screw holes 4 and 5 were replaced with 4.0 mm cancellous screws. The screw in hole 1 was redirected. (postoperative radiographs not shown).
