|Patient: 30 year old male|
|History: Patient complains of leg pain after MVA.|
|Findings: The lateral tibial plateaus of both knees are fractured. The fracture fragments are distracted, more significantly on the right and minimally displaced posterio-laterally on the left. There is lipohemoarthrosis of both joints.|
|Diagnosis: Bilateral lateral tibial plateau fractures, most consistent with type I.|
| Discussion: |
Force is directed through femoral condyles into tibial plateau.
Most common mechanism of injury is axial loading, but characteristically injury is sustained by being hit with car, “fender fracture.”
Kids: fracture is splitting
Adults: fracture is depressed
Medial plateau is stronger than the lateral, thus lateral tibial plateau fractures are more common. When medial plateau fracture does occur, often other fractures have occurred with it, for example, a lateral plateau fracture, as well as soft tissue injury (PCL, popiteal artery and menisci).
In general, depression of 4-5 mm and diastasis of 3-4 mm are surgical candidates.
I: split fx of lateral tibial plateau
II: split fx with depression of lateral articular surface
III: depression of lateral tibial plateau, without splitting the articular surface
IV: medial tibial plateau, may be split fx, may have depression
V: split fx through bilateral tibial plateaus (on a single knee)
VI: dissociation of the tibial plateau from underlying diaphysis
| References: |
Sorenson, S., Tibial Plateau Fractures, Emedicine, http://www.emedicine.com/RADIO/topic698.htm.
Submitted by Emily Janitz, DO and Stephen Passerini, MD attending radiologist Aultman Hospital
| Comments: |
No comments posted.
| Additional Details:|
Case Number: 5464326Last Updated: 09-15-2006 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.