ABSTRACT
Complex tibial plateau fractures are typically the result of high-energy blunt-trauma. The mechanism of this trauma transfers force to bone, cartilage, and soft tissue structures creating a combination injury, requiring a well-planned treatment strategy. The majority of these plateau fractures are bicondylar and display significant displacement. The results of nonoperative treatment are poor, yet even in the most experienced hands, operative treatment using standard techniques can produce further injury to an already compromised soft tissue envelope. The keys to successful outcome are: (i) restoration of articular cartilage, (ii) preservation of the biology, (iii) alignment of the mechanical axis, (iv) restoration of joint stability, and (v) preservation of functional motion.
