Learning objectives
Classify fracture patterns of tibial plateau using Schatzker and AO classification systems
Identify the indications for cross sectional imaging
Recognize the different indications for surgical intervention and be familiar with surgical hardware
Become familiar with the long term outcome of the different fracture patterns and surgical techniques
Background
Background:
The earliest attempt at tibial plateau fracture classification was based on the observation of common themes and three fracture types were described: split of a condyle,
subchondral depression,
and comminuted bicondylar involvement.
(1,2)
Schatzker et al.
presented their classification system in 1979,
which was created based on findings from AP radiographs.
The Schatzker group created 6 groups of tibial plateau fractures based on fracture pattern,
which helped to direct operative versus non-operative treatment.
(2)
The AO system is part of a larger system of...
Findings and procedure details
SCHATZKER CLASSIFICATION:6 types of tibial plateau fractures (3)
Type I: lateral split without depression
Type II: split-depression lateral plateau fracture
Type III: pure depression lateral plateau fracture- based on the classification system this pattern can be separated into A and B,
however,
this is not necessarily used in the clinical setting (IIIA: compression fracture of the lateral plateau; IIIB: compression fracture of the central plateau)
Type IV: medial plateau fracture
Type V: bicondylar plateau fracture
Type VI: meta-diaphyseal dissociation
Type I: (Fig.9 and 10)
Wedge...
Conclusion
CONCLUSIONS:
Classification systems can be useful to standard fracture pattern descriptions,
but may need to be updated or revised as imaging standards change.
Classification systems that are simple for both radiologists and orthopedic surgeons to understand are the most useful.
The more complex the system the more inaccuracy that occurs in classifying the fracture pattern.
Radiographs,
particularly with tibial plateau views,
are often sufficient to classify tibial plateau fracture patterns.
Cross sectional imaging can improve more accurate classification and address soft tissue injuries,
which may...
References
Gicquel T.,
Najhi N.,
Vendeuvre T.,
Teyssedou S.,
Gayet L.E.,
Huten D.
Tibial Plateau fractures: Reproducibility of three classifications (Schatzker,
AO,
Duparc) and a revised Duparc classification.
Orthopaedics and Traumatology: Surgery and Research.
2013; 99:805-816.
Zeltser D.W.,
Leopold S.S.
Classifications in Brief: Schatzker Classification of Tibial Plateau Fractures.
Clin Orthop Relat Res.
2013; 471:371-374.
Markhardt K.B.,
Gross J.M.,
Monu J.U.V.
Schatzker Classification of Tibial Plateau Fractures: Use of CT and MR Imaging Improves Assessment.
Radiographics.
2009; 29:585-597.
Hansen M.,
Pesantez R.,
Raaymakers E.,
Schatzker J....