Classification and Treatment Strategies of Concomitant Fibular Column Injuries in Tibial Plateau Fractures

Background. About 1/3 of tibial plateau fractures are associated with proximal fibula fractures, but most proximal fibula fractures are often ignored. The aim of this study was to precisely explain the classification and treatment strategies of six injury types of the fibular column associated with tibial plateau fractures. Methods. Patients with ipsilateral proximal fibula and tibial plateau fractures treated in our hospital were retrospectively reviewed from Aug 2007 to Mar 2020. Two experienced surgeons and two radiologists divided fibular column injury into 6 injury types according to the AO classification and four-column nine-segment classification. The treatment scheme (surgically treated or conservatively treated) was also recorded. Results. In total, 355 proximal fibula fractures were included. Type 2 fibular head fracture was the most common type of injury in 122, and the segregate of superior tibiofibular syndesmosis was the rarest type in 3. In avulsion injury proximal of fibular pattern, the proportion of patients who need surgical intervention is the highest. Conclusions. Six injury types in the four-column nine-segment classification covered all types of bony and soft tissue injuries of the fibular column and concisely explained the injury mechanism. The classification is helpful for the precise judgement and decision-making of the concomitant fibular column injuries in tibial plateau fractures.

Download Full-text

MR Imaging of Tibial Plateau Fractures: Evaluation of Fracture Types and Associated Soft Tissue Injuries

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1997.36.5.867 ◽

1997 ◽

Vol 36 (5) ◽

pp. 867

Author(s):

Geon Lee ◽

Chan Heo ◽

Yong Jo Kim ◽

Hyeok Po Kwon ◽

Jung Hyeok Kwon ◽

...

Keyword(s):

Soft Tissue ◽

Mr Imaging ◽

Tibial Plateau ◽

Soft Tissue Injuries ◽

Tibial Plateau Fractures ◽

Tissue Injuries ◽

Fracture Types

Download Full-text

Prediction of Soft-Tissue Injuries in Schatzker II Tibial Plateau Fractures based on Measurements of Plain Radiographs

Journal of Trauma and Acute Care Surgery ◽

10.1097/01.ta.0000203548.50829.92 ◽

2006 ◽

Vol 60 (2) ◽

pp. 319-324 ◽

Cited By ~ 43

Author(s):

Michael J. Gardner ◽

Shahan Yacoubian ◽

David Geller ◽

Matthew Pode ◽

Douglas Mintz ◽

...

Keyword(s):

Soft Tissue ◽

Tibial Plateau ◽

Soft Tissue Injuries ◽

Tibial Plateau Fractures ◽

Plain Radiographs ◽

Tissue Injuries

Download Full-text

The influence of arthroscopy on the classification and treatment of tibial plateau fractures

Journal of Orthopaedics ◽

10.1016/j.jor.2020.10.007 ◽

2020 ◽

Vol 22 ◽

pp. 520-524

Author(s):

Lauren M. Tatman ◽

Joost T.P. Kortlever ◽

Brian P. Cunningham ◽

David Ring ◽

Marc F. Swiontkowski

Keyword(s):

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Classification And Treatment

Download Full-text

Relative Incidence of Proximal Fibula Fractures with Tibial Plateau Fractures: An Investigation of 354 Cases

The Journal of Knee Surgery ◽

10.1055/s-0039-1681045 ◽

2019 ◽

Vol 33 (06) ◽

pp. 531-535

Author(s):

Yue Liu ◽

Yan Zhang ◽

Xu Liang ◽

Jin Shao ◽

Zisheng Ai ◽

...

Keyword(s):

Classification System ◽

Tibial Plateau ◽

Articular Surface ◽

Plain Radiography ◽

Tibial Plateau Fractures ◽

Posterior Column ◽

Diagnostic Study ◽

Lateral Column ◽

Proximal Fibula ◽

Fibula Fracture

AbstractWe aimed to investigate the incidence of proximal fibula fractures in patients with tibial plateau fractures and to identify risk factors for such combined injuries. From January 2011 to December 2015, 354 patients with tibial plateau fractures who had been admitted to a level 1 trauma center were retrospectively evaluated by an orthopaedic trauma surgeon and two skeletal radiologists. Anteroposterior plain radiography and computed tomography (CT) were used to characterize the injuries, and the incidence of associated proximal fibula fractures was determined. The tibial plateau fractures were classified according to the Schatzker's and three-column classifications. Associated proximal fibula fractures were simultaneously classified with a new fibula fracture classification system. Finally, we determined whether there were statistically significant associations between the presence of a proximal fibula fracture and different types of tibial plateau fractures, as well as sex and age. Proximal fibula fractures were detected in 192 (54.24%) patients using plain radiography and in 215 (60.73%) patients using CT. Logistic regression analysis indicated an increasing trend in the incidence of fibula fractures detected by the CT-based three-column classification system as follows: “age × sex > three columns > age > single posterior column > lateral column + posterior column > medial column + posterior column > medial column + lateral column > single lateral column > single medial column.” Proximal fibula fracture associated with tibial plateau fracture is a common phenomenon worthy of attention. In women, age increases the likelihood of complex tibial plateau fractures, particularly those involving the posterolateral articular surface and diaphysis, as well as the likelihood of developing proximal fibula fractures. This s Level IV diagnostic study.

Download Full-text

A PROSPECTIVE STUDY EVALUATING ASSOCIATION BETWEEN TIBIAL PLATEAU FRACTURE MORPHOLOGY WITH LIGAMENT AND MENISCAL INJURY AROUND KNEE.

10.36106/gjra/1811051 ◽

2021 ◽

pp. 33-35

Author(s):

Manoj Kumar ◽

Bharat Bhushan ◽

Arun Vaishy ◽

Rajendra Fageria ◽

Ramakishan Ramakishan

Keyword(s):

Soft Tissue ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Soft Tissue Injuries ◽

Fracture Morphology ◽

Tibial Plateau Fractures ◽

Meniscal Injury ◽

Classi Cation ◽

Plateau Fracture ◽

A Prospective Study

INTRODUCTION: In the modern world,due to advent of high speed motor vehicles , high energy trauma commonly involves the knee joint and results in complex tibial plateau fractures and associated ligament and meniscal injuries . Proper diagnosis and management of these injuries reduced the chances of degenerative changes around knee joint later on. MATERIAL AND METHOD: A prospective study was conducted in the Department of Orthopaedics in a tertiary health care center of western rajasthan from January 2018 to December 2020 . A total of eighty patients( 62 males: 18 females) with tibial plateau fractures and associated soft tissue injuries were included .Patients were assessed both clinically and radiologically and “ SCHATZKER'S classication was used to classify the tibial plateau fractures. Pre-operatively in every case CT-scan was used to study fracture pattern and MRI was done to see fracture morphology and associated soft tissue injuries. RESULT: A total 80 patient was included in our study,out of which 73 (91.25%) having ligaments( Cruciate and Collaterals) and meniscal injury . Injury to the lateral meniscus was found most frequently in Schatzker II fracture (p<0.0006) and medial meniscus in schatzker IV (p< 0.011). Variable association was shown by ACL and PCL injuries with tibial plateu fracture morphology ,but as the grade of designation increases within schatzker classication as does the frequency of cruciate ligament tear. Overall incidence of LCL rupture occurred least frequently in Schatzker II fractures (7 of 34; 20.5%), which was statistically signicant (P < 0.01). Complete MCL tear occurred in 27( 33.7%) of all fractures and in 41% of Schatzker II fractures. PLC tear had shown signicant association with medial tibial plateu fracture (schatzker IV). CONCLUSION: The likelihood of the cruciate , collateral ligament and PLC injury increases as the grade of designation within schatzker classication (schatzker I-VI). PLC injury had a signicant association with medial tibial plateu fracture (schatzker IV) and MCL had a signicant association with lateral tibial plateau fracture .

Download Full-text