Clinical Details

Clinical and radiological findings:  I intercepted this patient on their way to arthroplasty: double plate ORIF for a Schatzker V-VI bicondylar tibial plateau fracture, managed some 15 years ago with subsequent ROH. Initial CT slices demonstrate both the bicondylar nature as well as the degree of posterolateral plateau involvement. Considering the hardware choice and implant position, the posterolateral corner has predictably been missed by the fixation and remains mostly unreduced. Interestingly the majority of symtomatic collapse was medial sided. Based on pre and postop imaging one might believe the medial plateau was relatievly well preserved and adequately fixed - the suqbsequent varus collapse and complete loss of the medial column is impressive