In this situation, where the fragment is posterolateral, one needs a posterior approach, either as described by Timothy Bhatacharya et al in 2005 in JOT, which involves taking down the medial head of the gastrocnemius, or the Lobenhoffer paper which involves a transfibular approach.
Hope this helps.
would anyone consider an anterolateral approach with a sagital osteotomy just lateral to midline?
this would give access to the impacted posterior region. then "backgraft", and fix the osteotomy
fragment with a standard anterolateral plate. thanks.
