Posterolateral tibia plateau fractures: pros and cons of different surgical approaches

• Posterolateral tibial plateau fractures are complex injuries requiring a thorough understanding of the anatomical structures involved, including the popliteus tendon, lateral collateral ligament and posterior horn of the lateralmeniscus. • Standard anterolateral or midline approaches provide limited access to the posterolateral corner, often necessitating specific surgical techniques to achieve optimal fracture reduction and joint stability. • This review explores the main surgical approaches used for these fractures outlining their indications, advantages and limitations. • Each section provides a step-by-step guide for an effective surgical technique, based on experience from a high-volume trauma center, to optimize exposure, reduction and fixation. • Understanding the biomechanical and anatomical aspects of these fractures is crucial for selecting the most appropriate surgical strategy, minimizing complications and improving patient outcomes.