ECR 2015 / C-1752
Tibial plateau fractures: Review of the classification systems, management, and outcome
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Type:
Educational Exhibit
Keywords:
Trauma, Outcomes, Education and training, Education, Conventional radiography, CT, Musculoskeletal joint, Musculoskeletal bone
Authors:
S. L. Coleman, R. Parisien, A. Guermazi, A. Murakami; Boston, MA/US
DOI:
10.1594/ecr2015/C-1752
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 change management.
- CT imaging should be recommended when radiographs show condylar widening,
articular incongruity,
and depression/compression of the articular surface.
- The goal of treatment is to restore joint stability and functionality.
- Stability dictates operative management in low energy fracture patterns.
- Additional soft tissue injuries can influence surgical approach in high energy fracture patterns.
- Long-term prognosis is dependent on how well joint stability is preserved with treatment.