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Abstract Objective To evaluate the clinical effect and identify the advantages for the treatment of posterolateral tibial plateau fracture by using self-made anatomic plate for posterolateral condyle of tibial plateau with the supra-fibular-head approach.Methods 12 patients with posterolateral tibial plateau fracture were selected and treated from March 2016 to August 2018.They aged from 23 to 66 years with an average of (48.5±11.7)years.According to the 3D CT segmentation for lateral tibial plateau：12 cases had fracturein Ⅰ area；11 cases in both Ⅰ+Ⅱ areas；5 cases in Ⅰ+Ⅱ+Ⅲ areas.Self-made anatomic plate for posterolateral tibial plateau with the supra-fibular-head approach was applied to all these patients.After the operation，these patients hadperiodically follow-up，guidance for knee joint functional exercise and observation for postoperative complications.The fracture reduction was evaluated according to the Rasmussen score of the knee joint.The knee joint function was evaluated by thescore of the hospital for special surgery(HSS).Results The operation took 46~65 mins，average(51.5±5.9)mins.All of wounds healed by first intention without complications like infection，skin necrosis，osteomyelitis or nerves injuries etc.Follow-up period was 10~31 months，average(13.5±6.2)months.During this time period，there was no internal fixation failure，fracture or displacement.No knee joint instability or articular step-off，no malformation of knock knee or bow leg etcwere founded.Accordingto Rasmussen radiographic evaluation，clinical outcomes were excellentin 9 cases，goodin 2 cases，fairin 1 cases.It took 9~12 weeks for clinical fracture healing after the operation，with an average (10.8±1.2)weeks.Internal fixation was successfully taken out for 8 studies in 11~18 months after the operation，with an average (13.5±2.2)months.The mean HSS(the Hospital for Special Surgery)score of all patients were excellent in 10 cases，good in 1 case and fair in 1 case with the excellent and good rate was 91.7％.Conclusion These results reveal that the suprafibular-head approach is simple and safe，with minimal trauma and without the risk of blood vessels or nerves injuries.The anatomic plate for posterolateral tibial plateau can have a direct and efficient support to the fracture fragments.The combination use of both has an obvious advantage to treat posterolateral tibial plateau fractures，which is worth learning and promoting.
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