Mohammad Tahami - ۱ Bone and Joint Disease Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ۲ Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammadnaghi Tahmasebi - Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Arash Sherafatvaziri - Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
Rodrigo Pesantez Hoyos - Department of Orthopaedic and Trauma Surgery, Fundacion Santa Fe de Bogotá, Universidad de los Andes, Colombia
Mohammadreza Bozorgmanesh - Vali-e-Asr Hospital, Arak University of Medical Sciences, Arak, Iran

There is no agreement on the best surgical strategy to manage multicolumnar tibial plateau fracture. The combined approach used by many investigators has been found to be an effective method. However, combined approaches call for repositioning the patient which lengthens the operation time. The sterility of the field of surgery might be jeopardized by repositioning. Intraoperative fluoroscopic imaging is hard to adjust to both parts of the combined positions. To tackle these problems without sacrificing the concept of three-column tibial plateau, we have started to use a combined medial and lateral approach without repositioning the patients using a modified semi-lithotomy position. Level of evidence: V

Combined approach, Fracture, Position, Tibial Plateau, Trauma