Extended anterolateral versus Frosch approach for type II tibial plateau fractures involving the posterolateral column: A retrospective case series study

This study aimed to compare the extended anterolateral approach and the Frosch approach for treating type II tibial plateau fractures (based on the Schatzker classification system) involving the posterolateral column. A retrospective study was undertaken to compare general patient characteristics, intraoperative and postoperative outcomes, the Hospital for Special Surgery score, Rasmussen radiology score, tibial plateau angle, and posterior slope angle immediately after surgery and at a 1-year follow-up, between the 2 surgical approaches utilized between 2016 and 2020. Fifty-two patients with Schatzker type II fractures from Ningbo No. 2 Hospital were enrolled. No significant demographic differences existed between the 2 surgical groups. The Frosch approach group had slightly longer operative times but better hospital for special surgery knee scores and Rasmussen radiology scores than the extended anterolateral approach group. Both approaches achieved good outcomes for simple posterolateral fractures. For complex fractures, the Frosch approach may enabled more accurate reduction and superior biomechanical stability.