Lin DC, Hu TY, Zhou YJ, Zhang ZW, Yuan JJ, Lu CX, Zheng LN. Modified Gerdy tubercle osteotomy in the treatment of posterolateral tibial plateau depression fractures: Technical report and preliminary results. World J Clin Cases 2026; 14(20): 121215 [DOI: 10.12998/wjcc.121215]
Corresponding Author of This Article
Tian-Ye Hu, MD, Academic Fellow, Department of Orthopaedics, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Gongshu District, Hangzhou 311000, Zhejiang Province, China. dr_hutianye@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dao-Chao Lin, Tian-Ye Hu, Department of Orthopaedics, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 311000, Zhejiang Province, China
Yi-Jun Zhou, Zhi-Wu Zhang, Jia-Jun Yuan, Chen-Xiao Lu, Lu-Na Zheng, Department of Orthopedics, Shulan (Hangzhou) Hospital Affiliated to Shulan International Medical College, Hangzhou 311000, Zhejiang Province, China
Co-first authors: Dao-Chao Lin and Tian-Ye Hu.
Author contributions: Hu TY designed this study; Lin DC, Hu TY, Zhou YJ and Zhang ZW performed the surgery; Zheng LN followed up patients and collected data, Lu CX, Yuan JJ and Hu TY carried out statistical analysis and wrote this paper; and all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Shulan (Hangzhou) Hospital Institutional Review Board (Approval No. Yj2022018).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: DTechnical appendix, statistical code, and dataset available from the corresponding author at dr_hutianye@163.com. Participants gave informed consent for data sharing.
Corresponding author: Tian-Ye Hu, MD, Academic Fellow, Department of Orthopaedics, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, No. 848 Dongxin Road, Gongshu District, Hangzhou 311000, Zhejiang Province, China. dr_hutianye@163.com
Received: March 19, 2026 Revised: April 7, 2026 Accepted: June 5, 2026 Published online: July 16, 2026 Processing time: 113 Days and 2.5 Hours
Abstract
BACKGROUND
Tibial plateau fractures are clinically common. Among various classification systems, the six-type Schatzker classification is most widely used. This report focuses on Schatzker type 3 (simple lateral plateau depression fracture) and type 5 with lateral plateau depression. Depression fractures can occur anywhere on the lateral plateau, most commonly in the central-posterior region. Uncorrected intraoperative depression may cause knee bony instability and impair joint function.
AIM
To modify Gerdy tubercle osteotomy was used to treat these fractures, yielding favorable postoperative and functional outcomes of the knee.
METHODS
This study included a cohort of 18 patients, including 11 males and 7 females, 10 left knees and eight right knees. The age ranged from 30 years to 56 years, with an average of 35.6 years. All 18 patients were treated with modified Gerdy tubercle osteotomy and followed up until the end of the observation. Radiological outcomes including fracture reduction loss and fracture healing were assessed via postoperative follow-up knee X-ray and computed tomography examination. Knee functional recovery was evaluated using the Hospital for Special Surgery score and Lysholm knee score.
RESULTS
By the end of follow-up, no fracture loss was observed in any of the patients, and the fractures were completely healed. According to the Lysholm knee function score, 15 cases were excellent, two were good, and one was fair, with an excellent-good rate of 94%. According to the Hospital for Special Surgery score, 14 cases were excellent, three were good, and one was fair, with an excellent-good rate of 94%.
CONCLUSION
The modified Gerdy osteotomy method for treatment of posterolateral tibial plateau depression fractures involves a simple surgical operation, satisfactory fracture reduction, and excellent recovery.
Core Tip: This study focused on Schatzker type 3 (i.e., simple lateral plateau depression fracture) and Schatzker type 5 with lateral plateau depression fractures. Schatzker type 3 fractures are mostly caused by direct impact of the femoral condyle on the lateral plateau. The depressed fracture can occur at any position on the lateral plateau, and the central-posterior position is more common. If the depression is not corrected during surgery, it may cause knee joint bony instability and have a significant impact on joint function. We used the modified Gerdy tubercle osteotomy to treat this type of fracture and achieved good results.
