MyPACS.net: Radiology Teaching Files > Case 5464326

previously visited TIBIAL PLATEAU FRACTURE
Contributed by: Radiology Residency Program Faculty & Staff, Northeastern Ohio Universities College of Medicine-Canton Affiliated Hospitals, Ohio, USA.
Patient: 30 year old male
History: Patient complains of leg pain after MVA.
Images:[small]larger

Fig. 1

Fig. 2

Fig. 3

Fig. 4: Another view of the left.
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.


Schatzker Classification

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
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional RadiographAccess Level: Readable by all users

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