Anatomical description of a new posterolateral double-window approach for the management of tibial plateau fractures.

INTRODUCTION: anatomical reduction and stable fixation are crucial in the treatment of articular fractures to prevent post-traumatic osteoarthritis and joint dysfunction. However, surgical exposure of the lateral tibial plateau remains a challenge, especially in the posterolateral column. New approaches are needed to provide adequate visualization of the articular surface. This study aims to anatomically describe a posterolateral double-window approach (anterior and posterior to the biceps femoris) in cadaveric specimens, optimizing surgical exposure without the need for osteotomies. MATERIAL AND METHODS: dissections were performed on two knee specimens, employing a posterolateral double-window approach (anterior and posterior to the biceps femoris). The exposed tibial surface was measured using a uniplanar ruler, and the percentages of lateral tibial plateau visualization were calculated. RESULTS: in the left knee, the exposure of the anterolateral quadrant was 82%, and in the posterolateral quadrant was 66%. In the right knee, 70 and 66% were obtained, respectively. The anterolateral window provided greater exposure compared to the posterolateral one. CONCLUSION: this technique represents a viable surgical option to optimize tibial exposure without osteotomies. Clinical studies are needed to validate its impact on functional recovery in patients.