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Introduction: Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results., Material and Methods: Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2 mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up., Results: The last follow-up was at 24 months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6-7) vs. 7 (6-8, p  = 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation ( p  < 0.001). The full range of motion was seen in all patients except one who was manipulated after three months., Conclusions: Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures., Level of Evidence: IV., Competing Interests: Conflict of InterestThe authors have no conflicts of interest to declare that are relevant to the content of this article., (© Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: This study aimed to report objective and subjective knee stability scores for patients who underwent acute repair of avulsed posterolateral corner (PLC) structures or acute reconstruction of midsubstance tears combined with delayed reconstruction of cruciate ligaments., Methods: A total of 48 sport and vehicle accident traumatic patients were enrolled in a three-year follow-up study. The patients were investigated by clinical exams, subjective and objective International Knee Documentation Committee (IKDC) score, Tegner score, Lysholm score, and stress imaging. All scores were compared between the reconstruction and repair groups., Results: Subjective IKDC scores were obtained at 83.3±9.6 and 88.3±4.39 for the reconstruction and repair groups, respectively. Only two patients in the reconstruction group had abnormal objective IKDC scores. Based on the Tegner score, 15 out of 18 patients in the repair group and 20 out of 24 patients in the reconstruction group regained their pre-injury functional level. Mean Lysholm scores for the reconstruction and repair groups were estimated at 83.4±8.2 and 88.2±4.1, respectively. Mean lateral joint opening differences between two knees in the reconstruction and repair groups were -0.2±0.1mm and 0.5±0.1mm, respectively. There were no statistically significant differences between groups outcomes. We had no failure of treatment at the final follow-up., Conclusion: Acute intervention within 3 weeks after PLC injuries combined with delayed cruciate ligaments reconstructions showed favorable outcomes. Both repair and reconstruction are effective when deciding based on the type of injury (i.e., avulsion and midsubstance tear)., Competing Interests: The authors declare that there is no conflict of interest.