Fig. 4.

50 year old male with a comminuted lateral tibial plateau fracture (a–d). All segments of the lateral plateau are involved including both central segments (AC—anterior cruciate ligament, PC—posterior cruciate ligament). To reduce the fracture under full visual control including the whole lateral plateau and central segments, an extended approach with osteotomy of the lateral epicondyle [10, 12, 13] and a central subluxation of the lateral meniscus [31] were stepwise performed (e). With this treatment regimen an complete anatomic reduction of the articular surface was achieved (f, g). Fixation was performed by screws, lateral plate and a spongiosa allograft block underneath the articular surface after reduction of the fracture.