The patient sustained a tibial plateau fracture treated with circular frame fixation. The proximal tibia healed with a depressed lateral articular fragment and excessive condylar width. As a result, the femoral condyle articulated on the depressed tibial surface, causing lateral knee pain and instability.

The aim was to restore joint congruity and condylar width. A patient-specific cutting guide was designed to remove a controlled sagittal “slice” of the depressed lateral plateau, positioned lateral to the tibial tubercle to protect the patellar tendon and beneath the meniscus. The lateral tibial condyle would then be repositioned and fixed with a custom plate contoured to the complex bone surface.

Insight Surgery provided anatomical models for presurgical planning and a surgical guide which enabled precise osteotomy placement and safe resection of the depressed fragment while preserving surrounding structures. Integrated pre-drilling channels aligned fixation with the planned custom plate (provided by Osteobionix), confirming accurate intraoperative transfer of the surgical plan.

Anatomic repositioning of the lateral tibial condyle restored proximal tibial width and joint alignment. Custom plate fixation stabilised the correction and matched the irregular post-traumatic bone. Joint congruity was restored, addressing the mechanical source of pain and instability and improving expected function.