Introduction: Due to its special location, it is difficult to perform open reduction and internal fixation, if early effective treatment is not provided for patients, chronic collapse often occurs, which leads to significant limited range of knee flexion and extension. It is pivotal to find an approach with more accurate exposure of fracture and more operable fixation to obtain better outcome of treatment for PTPF. Aim: to evaluate the outcome of prone and direct posterior approach for management of posterior column tibial plateau fracture in terms of clinic radiological and functional outcome. Material and methods: Prospective hospital based descriptive study conducted in Department of Orthopedics in teaching hospitals attached to SMS Medical College and Hospital from January 2017 to May 2018, on 36 subjects. Patients were seen for clinical and radiological assessment at 15 days, 3rd month and 6th months interval and outcome analysed by Lysholm score, Tegner score and RUST criteria for radiological union. Observation: There was a significant increase in the scores 1.17 ± .97; p <0.001S in Tegner score between 3 month and 15 days. Significant improvement (6.00 ± .93; p <0.001S) was observed in score on applying paired-samples t- to compare Lysholm Score between 6 month and 15 daysThere was a significant increase in the RUST criteria between 6 month and 3 month scores 3.47 ± 1.44; p < 0.001S. These results suggest that operation really effective for improvement of the disease conditions. Conclusion: Using the prone posterior approach with a reverse L-shaped incision to manage fragments of the posterior column in tibial condylar fractures can achieve anatomic reduction and rigid fixation, resulting in a good functional outcome by buttressing the posteromedial fragment by plate and buttress effect preventing descent of the fragment under load than other modes of fixation.

Keywords: Prone posterior approach; Tibial condylar fractures; Lysholm Score; RUST criteria