Discussion on the classification and treatment strategies of the lateral condylar tibial plateau fractures

Objective To discuss on the ABC classification of the lateral condylar tibial plateau fractures, and to evaluate its clinical application. Methods From March 2013 to June 2015, 87 patients with lateral condylar tibial plateau fracture were treated in our hospital, including 49 males and 34 females with the mean age of 49.1 years (range, 25-76). A new classification system of the lateral condylar tibial plateau fracture, ABC Classification, was used for all the 83 patients. There were 51 patients for type B, 6 for type C, 9 for type AB, 13 for type BC, 4 for type ABC. Surgery approach and fixation method depended on the type of fracture. Anterior-lateral approach and anterolateral locking plate fixation were used to treat type B and AB, and additional marginal plate were used in type AB. Carlson approach and T-buttress plate fixation were used to treat type C. Frosch approach was used to treat type BC and ABC. The radiographic and clinical results were evaluated by using Rasmussen's radiological and HSS grading at 12 months postoperatively respectively. Results 83 patients underwent surgeries successfully, with average time of 121 mins (range, 90-160 mins). With a follow-up rate of 83.1%, 69 patients were followed up for 12-24 months, the mean follow-up time was 14.6 months. There was no significant difference in fracture healing time of different types. The average time for fracture union were 13.5 weeks (range, 12-16 weeks). The mean score of the Rasmussen's radiological grading was 16.9 (range, 13-18). All the results according to HSS grading are excellent and the mean score of the HSS grading was 94.1 (from 82-98). Conclusion CT-based ABC Classification is worthy of popularization and application in clinics, and it is more reliable and instructive in the treatment of lateral condylar tibial plateau fractures. Key words: Tibia fractures; Fracture fixation, internal; Diagnosis