25dkou421 10.3205/25dkou421 urn:nbn:de:0183-25dkou4211 Meeting Abstract Fahlbusch Fahlbusch Hendrik H

Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Unfallchirurgie, Hamburg, Deutschland

author Behrendt Behrendt Peter P

University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Anatomy, Christian-Albrechts-University, Kiel, Deutschland

author Arras Arras Christian C

Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Unfallchirurgie, Hamburg, Deutschland

author Gablac Gablac Hannah H

Asklepios Klinik St. Georg, Zentrum für Muskuloskelettale und Plastische Chirurgie Unfallchirurgie, Orthopädie und Sportorthopädie, Hamburg, Deutschland

author Frings Frings Jannik J

Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Unfallchirurgie, Hamburg, Deutschland

author Hoffmann Hoffmann Michael M

Asklepios Klinik St. Georg, Zentrum für Muskuloskelettale und Plastische Chirurgie Unfallchirurgie, Orthopädie und Sportorthopädie, Hamburg, Deutschland

author Krause Krause Matthias M

Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Unfallchirurgie, Hamburg, Deutschland

author Frosch Frosch Karl-Heinz KH

Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Unfallchirurgie, Hamburg, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 421 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Kniechirurgie Berlin 20251028 20251031 AB66-2228 TextObjectives and questions: Does the use of lateral epicondyle osteotomy (ECO) in the surgical treatment of severe lateral tibial plateau fractures involving the central and postero-lateral regions lead to improved clinical and radiological outcomes compared to a conventional approach without the extension?Material and methods: A retrospective cohort study was conducted at two centers, examining complex lateral tibial plateau fractures treated with either an extended lateral approach with ECO or without it. Only AO/OTA type B3/C3 fractures involving the antero-latero-central (ALC) and postero-latero-central (PLC) segments were included. Fracture reduction quality was assessed via post-operative CT scans, and clinical outcomes and complications were evaluated over a minimum of 24-month follow-up.Results: A total of 110 patients (mean age: 51.3 ± 11.1 years) were included, with an average follow-up of 52.7 ± 16.9 months. The ECO group (n=56) consisted of more severe injuries, indicated by higher external fixator use (48.2% vs. 22.2%, p=0.0044) and additional affected segments. Postoperative CT scans revealed that the ECO group had significantly less fracture step-off (0.8 mm vs. 3.0 mm, p=0.0002) and angulation at the ALC/PLC (8.1° vs. 20.1°, p=0.0002) segment and PLC/PLL (postero-latero-lateral) (2.2° vs. 7.5°, p=0.02) segments. Clinically, the ECO group achieved superior IKDC scores (71.7 vs. 63.7, p=0.0097). A negative correlation was found between postoperative ALC/PLC depression and IKDC scores (r=-0.36, p=0.0002).Discussion and conclusion: Patients treated with ECO had a significantly better clinical and radiologic postoperative outcomes, with the quality of fracture reduction positively correlating with the clinical IKDC score. This was achieved despite more severe injuries, as indicated by higher external fixator use and number of affected segments. 0 0 0 0