The "Windowing" Technique and the "Open Book" Technique in Schatzker Type II Tibial Plateau Fracture

What is it about?

Schatzker type II tibial plateau fracture represents the most common type of all tibial plateau fractures. In our clinical practice, “windowing” technique and “open book” technique are two main surgical methods applied in open reduction and internal fixation of the fracture. Surgeons may choose one of the techniques upon their preference and proficiency. However, the techniques have their own advantages and disadvantages. We may use one of them upon fracture characteristics. In the study, we find that “windowing” technique can solve a majority of Schatzker type II fracture except two situations. It was tough for surgeon to get reduction through a cortical window against depressed zone of articular margin, especially anteriorly. Furthermore, surgeons can hardly obtain good intraarticular view of depressed zone involving tibial intercondylar eminence and posterior part of tibial plateau by retracting the meniscus superiorly. In this case, “open book” technique may be an effective alternative for the fracture.

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Why is it important?

Using “windowing” technique, more patients had good outcome with a better radiological outcome and a lower rate of severe post-traumatic arthritis, compared with the group of “open-book” technique. However, “open book” technique can be an effective alternative when depressed zone involves tibial intercondylar eminence or anterior margin.

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