TIBIAL PLATEAU [CASE 03] Posterolateral Depression

This orthopedic trauma learning case reviews the surgical management principles for a posterolateral depression fracture of the tibial plateau. The lesson emphasizes anatomical exposure of the lateral knee, use of limb positioning and varus stress to improve visualization, careful preservation and retraction of the meniscus, direct assessment of the articular depression, and reduction with subchondral support. The case also discusses decision-making around alternative approaches, including why a posterolateral approach or fibular osteotomy may be avoided in selected scenarios. Learners follow the sequence from incision planning and soft-tissue handling to elevation of the depressed fragment, bone void filling, fluoroscopic assessment, and screw placement using a subchondral support or 'jail' configuration. The content is intended for procedural education and anatomical reasoning, not as a substitute for supervised surgical training or clinical judgment. Included Content Case-based surgical anatomy review of the knee and tibial plateau Discussion of posterolateral depression fracture morphology Positioning strategy for varus-assisted lateral exposure Stepwise lateral approach with preservation of the tibialis anterior muscle Meniscal elevation, protection, and repair technique concepts Articular depression elevation using an osteotome Use of fluoroscopy to assess reduction and implant position Bone void filling with structural granular graft material Subchondral screw support strategy using crossed screw configuration Final construct review and closure sequence Target Audience Orthopedic trauma surgeons Orthopedic surgery residents and fellows Trauma and reconstruction fellows Medical educators in musculoskeletal trauma Advanced learners studying periarticular fracture fixation Educational Notice This content is intended for medical education and procedural discussion only. It does not provide patient-specific medical advice, does not replace formal surgical training, and should not be used as a standalone guide for clinical care. All procedural decisions require appropriate patient evaluation, institutional standards, supervision when applicable, and review by qualified medical professionals.