Case: Three patients with central-lateral depression (CLD) fractures of the tibial plateau with an intact lateral cortical rim were treated using a lateral tibial plateau intra-articular osteotomy (LPO). These fractures are particularly challenging because of poor visualization of the articular surface and reliance on indirect reduction techniques in standard approaches often leading to malreduction. Osteotomy provides direct access to the depression, allows easy meniscal retrieval, anatomical reduction, bone grafting, and stable fixation. All patients achieved union and good functional outcomes. Conclusion: LPO may be useful in deep, angulated, or reverse-slope CLD fractures where standard approaches limit visualization and direct reduction. Level of Evidence: V. Level of Clinical Care: Level I Tertiary trauma centre.
Devendra et al. (2026) studied this question.