Abstract
Severely depressed plateau fractures, especially Hohl I, III, can not be reduced by
ligamentotaxis and require elevation through a cortical window, bone grafting, and fixation with
either cancellous screws or a buttress plate. But traditional long lateral parapatellar incision and
plate fixation method caused frequent wound dehiscence and deep infection. Thus to reduce the
soft tissue problem we treated Hohl II, III plateau fractures by small anterolateral L-shaped
incision, submeniscal exposure, reduction of depressed plateau and bone graft through bone
window, and then cancellous screws fixation beneath the subchondral bone of elevated plateau.
We anayzes 22 cases with Hohl II, III plateau fractures, which were treated by these method
from February 1990 to December 1997 and followed more than 1 year. Males were 17, and
females were 5. Average age of patients was 44.7 years. The most common cause of injury was
traffic accidents(17 cases), and fracture type according to the Hohl classification was 14 cases
of type II, 8 of type III. The associated injuries were 18 cases of meniscus tear, 13 of ligament
injury(6 ACL, 7 MCL). The clinical results by Blokkers criteria were satisfactory 19
cases(86.3%) and unsatisfactory 3 cases(13.7%). We concluded that this method has following
advantages; relatively firm fracture fixation, short operation time, low soft tissue problem.