Tibial Plateau Fractures
Original Editors - Jentel Van De Gucht
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Definition/Description [edit | edit source]
Tibial plateau fractures are complex injuries of the knee. The tibial plateau is one of the most critical load-bearing areas in the human body. Early detection and appropriate treatment of these fractures are essential in minimizing patient disability in range of motion and stability and reducing the risk of documented complications. [1]
The fractures are classified according the Schatzker classification system. It divides tibial plateau fractures into six types:
• Schatzker I: lateral tibial plateau fracture without depression
• Schatzker II: lateral tibial plateau fracture with depression
• Schatzker III: compression fracture of the lateral (IIIa) or central (IIIb) tibial plateau
• Schatzker IV: medial tibial plateau fracture
• Schatzker V: bicondylar tibial plateau facture
• Schatzker VI: tibial plateau fracture with diaphyseal discontinuity [2][3]
A type I fracture is a wedge-shaped pure cleavage fracture of the lateral tibial plateau, where is a displacement or depression less than 4mm. they are caused by the lateral femoral condyle being driven into the articular surface of the tibial plateau.
Type II is a fracture with a combined cleavage and compression of the lateral tibial plateau, a type I fracture with a depressed component. There is a depression greater than 4mm.
A Schatzker type III fracture is a pure compression fracture of the lateral tibial plateau in which the articular surface of the tibial plateau is depressed and driven into the lateral tibial metaphysis by axial forces. Type III fractures are divided into two subgroups: those with lateral depression (type IIIA) and those with central depression (type IIIB).
Type IV is a medial tibial plateau fracture with a split or depressed component. These fractures occurs as a result of varus forces combined with axial loading in a hyperflexed knee. Type IV fractures have the worst prognosis.
Type V fracture consists of a wedge fracture of the medial and lateral tibial plateau, often with an inverted “Y” appearance. Articular depression is typically seen in the lateral plateau, and there may be associated fracture of the intercondylar eminence.
Type VI is a bicondylar fracture with a dislocation of the metaphysis from the diaphysis.This pattern results from high-energy trauma and diverse combinations of forces. [2]
The first three types are mostly the result of low energy injury, the three others of high energy injury. The magnitude of the force determined the degree of fragmentation and the degree of displacement.
Tibial plateau fractures are often associated with anterior cruciate ligament, collateral ligaments (MCl and/or LCL), menisci and articular cartilage injuries[2]
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References[edit | edit source]
- ↑ Vidyadhara S, Tibial Plateau Fractures, eMedicine Specialties, 2009
- ↑ 2.0 2.1 2.2 B. Keegan Markhardt, Jonathan M. Gross, Johnny Monu, Schatzker Classification of Tibial Plateau Fractures: Use of CT and MR Imaging Improves Assessment, the journal of continuing medical education in radiology, 2009, 29, 585-597
- ↑ Hoppenfeld S, L. Murthy V., treatment & rehabilitation of fractures, lippincott williams and wilkins, 2000
