An Innovative Ergonomic Positioning Technique for Complex Proximal Tibial Fractures and Review of Literature

Tibial plateau fractures are common injuries across various age groups, often caused by axial, bending, and rotational forces. Managing these fractures requires an effective surgical approach that allows for comprehensive exposure of the fracture site, facilitating reduction and fixation while minimizing complications. This manuscript introduces an innovative ergonomic positioning technique for complex proximal tibial fractures. The patient is positioned on a fracture table with the opposite limb in a lithotomy position, allowing for accessible anterolateral and medial approaches using traction. Tilting the table provides easier access to posteromedial and posterolateral approaches. However, this method is not suitable for direct posterior access. The technique simplifies fluoroscopic placement and offers flexible surgeon positioning, improving visualization and overall surgical outcomes. While this positioning is advantageous for most proximal tibial fractures, it has limitations, such as traction injuries and incompatibility with arthroscopy-assisted fixation.