The Clinical and Commercial Synergy of the Proximal Tibial Lateral Locking Plate

medial plateau fracture (fracture/knee subluxation)

Type V:

Bicondylar fracture involving medial and lateral plateau splits

Type VI:

Bilateral plateau fracture with separation of tibial metaphysis from tibial stem

Absolute indications

• Joint surface collapse >2mm or lateral displacement >5mm

• Open fracture/combination of osteofascial compartment syndrome

• Knee instability (internal/external rotation >5°) or ligamentous injury requiring repair.

Relative indications

• Elderly patients requiring early mobilisation

• Combined meniscus injury requiring arthroscopic exploration

1. Surgical access

The surgical incision is chosen to be either lateral or medial to the knee, depending on the fracture site. The lateral incision is commonly used for lateral plateau fractures, extending from the lateral femoral condyle down to the lateral tibial tuberosity. The skin is cut and then separated layer by layer, paying attention to the protection of the common peroneal nerve, and the movement should be gentle when exposing the fracture end to avoid aggravating the soft tissue injury.

2. Repositioning of the articular surface

The collapsed articular surface is raised with a periosteal stripper, and the process is confirmed by repeated fluoroscopy with a C-arm machine. For comminuted fractures, sometimes it is necessary to implant allograft or artificial bone support below the articular surface. The joint surface should be flat and the difference in height from the healthy side should not be more than 2 mm, which directly determines the recovery of the joint function after the operation.

3. Follow-up

Complex fractures involving the metaphysis require supportive plate fixation, with L-shaped locking plates commonly used for the lateral plate and T-shaped plates for the medial one. For bicondylar fractures, some surgeons choose bilateral plate fixation, but care should be taken to avoid excessive stripping of the periosteum, which may affect the blood supply.

Anatomical Fit:

Pre-shaped design for Asian, African, and Latin American populations with tibial morphology (biomechanical comparison charts can be attached).

Multi-axial locking screw system adapts to different bone densities (e.g., osteoporosis in older African adults, high-energy trauma in Asian young adults)

Cost-benefit ratio:

Increased single procedure success rate and reduced revision costs (compare conventional plate data)

High durability and reduced frequency of instrument replacement in remote areas.

Operator Friendliness:

Simplified surgical process (e.g., MIPO minimally invasive technique), shortened learning curve for surgeons.

Portable supporting tools for resource-limited areas