Correlation of parameters on preoperative CT images with intra-articular soft-tissue injuries in acute tibial plateau fractures: A review of 132 patients receiving ARIF

Tang, Hao-Che; Chen, I-Jung; Yeh, Yu‐Cheng; Weng, Chun-Jui; Chang, Shih-Ying; Chen, Alvin Chao‐Yu; Chan, Yi‐Sheng

doi:10.1016/j.injury.2017.01.043

Cited by 30 publications

(25 citation statements)

References 32 publications

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“…The tibial plateau fracture may combine with soft tissue injuries around the knee joint. [9][10][11] Abdel-Hamid et al 9 stated that 71% of tibial plateau fractures had some associated soft tissue injuries, and the ACL injury was the second most common injury, mainly in types IV and VI tibial plateau fractures. Huang et al 10 also confirmed that the cruciate and collateral ligaments could be observed in types V and VI tibial plateau fractures.…”

Section: Discussionmentioning

confidence: 99%

The “Diagonal” Lesion: A New Type of Combined Injury Pattern Involving the Impingement Fracture of Anteromedial Tibial Plateau and the Injury of Posterior Cruciate Ligament and Posterolateral Corner

Song

et al. 2019

J Knee Surg

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The purpose of this study was to investigate the incidence and clinical characteristics of the “diagonal” lesion. A total of 273 consecutive patients with combined posterolateral corner (PLC) and posterior cruciate ligament (PCL) injuries were retrospectively analyzed. All preoperative knee joint evaluations were reviewed including the computed tomography, the anteroposterior (AP) view, the lateral view, the full-length long-standing AP view, and the physical examination results with the patient under anesthesia. Twenty-six patients (9.5%) were verified as having the “diagonal” lesions. The anteromedial impingement fractures could be categorized into small (small fracture group, n = 7) and large (large fracture group, n = 19). The PCL injuries were classified into grade 2 (n = 22) and grade 3 (n = 4). The PLC injuries could be classified into type A (n = 3), type B (n = 8), and type C (n = 15) according to the Fanelli's classification system. Notably, there were 20 chronic cases. Among them, 14 (70%) had varus deformities. The proportion of patients with varus deformity in the large fracture group was significantly higher than that of the small fracture group (p = 0.026). In this study, the incidence of the “diagonal” lesions was 9.5%. Patients who had larger fracture size tended to develop subsequent varus deformity of the lower extremity. It was important for us to recognize the PCL/PLC injuries and to fully reduce the large bony fracture during the initial treatment of the “diagonal” lesions to prevent the residual instability and varus deformity.

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Section: Discussionmentioning

confidence: 99%

The “Diagonal” Lesion: A New Type of Combined Injury Pattern Involving the Impingement Fracture of Anteromedial Tibial Plateau and the Injury of Posterior Cruciate Ligament and Posterolateral Corner

Song

et al. 2019

J Knee Surg

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“…The fact is that tibial plateau fractures are often combined with knee ligament and meniscus injuries. According to relevant studies, the probability of tibial plateau fracture with meniscus injury is approximately from 28.6% to 81.0% and lateral meniscus injury is dominant [5][6][7][8][9]11,12]. For Schatzker II tibial plateau fractures characterized by lateral spilt depression, Stahl et al [13] have previously pointed out that there is a 45.0% possibility of lateral meniscus injury.…”

Section: Discussionmentioning

confidence: 99%

“…Durakbasa et al [5] reported 20 cases of Schatzker type II plateau fracture with lateral plateau X-ray images and intraoperative direct vision of lateral meniscus, and demonstrated that a plateau depression ≥14 mm and/or widening ≥10 mm is related with a signi cantly high risk of meniscus injury. Furthermore, Tang et al [11] compared the CT presentations with arthroscopic examination results of 132 patients of Schatzker I-VI plateau fractures, among which 25 cases were type II fractures. The results showed that the positive incidence of lateral meniscus injury was about 70.3% when plateau collapsed >11mm.…”

Section: Discussionmentioning

confidence: 99%

“…According to the Chinese experts' consensus on the diagnosis and treatment of tibial plateau fractures published in 2015, there is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. In recent years, some clinical studies have pointed out that preoperative knee X-ray and CT examination can also indicate tibial plateau fracture combined with soft tissue injury, especially meniscus injury [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

Ying¹,

Zhu²,

Ding³

et al. 2021

Preprint

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Background: There is a great deal of controversy on whether routine MRI examination is needed for fresh fractures while the vast majority of patients with tibial plateau fractures receive preoperative X-ray and CT examinations. The purpose of the study was to analyze the exact correlation between CT images of lateral plateau and lateral meniscus injuries in Schatzker II tibial plateau fractures. Methods: Two hundred and ninety-six Schatzker II tibial plateau fracture patients from August 2012 to January 2021 in two trauma centers were enrolled for the analysis. According to the actual situation during open reduction internal fixation (ORIF) and knee arthroscopic surgery, patients were divided into meniscus injury (including rupture, incarceration, etc.) and non-meniscus injury groups. By measuring the value of both lateral plateau depression (LPD) and lateral plateau widening (LPW) of lateral tibial plateau on the coronary CT images, the correlation of which and lateral meniscus injury was analyzed. Meanwhile, the relevant receiver operating characteristic (ROC) curve was drawn to evaluate the optimal operating point of these two indicators which could predict meniscus injury. Results: Meniscus injury group mainly showed injuries involving the mid-body and posterior horn of the meniscus (98.1%, 157/160). The average LPD was 13.2 ± 3.2 mm, while the average value of the group without meniscus injury was 9.4 ± 3.2 mm. The difference was statistically significant (P < 0.05). The average LPW was 8.0 ± 1.4 mm and 6.8 ± 1.6 mm in two groups with a significant difference (P < 0.05). The optimal operating point of LPD and LPW was 7.9 mm (sensitivity-95.0%, specificity-58.8%, area under the curve (AUC-0.818) and 7.5 mm (sensitivity-70.0%, specificity-70.6%, AUC-0.724), respectively. Conclusions: The mid-body and posterior horn of lateral meniscus injury is more likely to occur in patients who had Schatzker II tibial plateau fractures when LPD > 7.9 mm and/or LPW > 7.5 mm on CT manifestations and these findings will definitely provide guidance for orthopedic surgeons in treating such injuries. During the operation, more attention should be paid to the treatment of the meniscus and full consideration is needed be taken to situations such as meniscus rupture, incarceration and other possible fracture reduction difficulties, poor vertical line, etc., in order to achieve better surgical results.

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“…An magnetic resonance imaging (MRI) can adequately show intra-articular soft-tissue injuries. [ 14 ] MRI examination was more accurate in diagnosing ACL injuries than meniscal injuries. Although MRI was regarded as a tool in the diagnosis of internal derangements of the knee, the longer scan time, higher cost, and lack of availability limit its use in the setting of acute tibial plateau fractures.…”

mentioning

confidence: 99%

New Developments in Treatments of Tibial Plateau Fractures

Liu

Zhou

Liu

2017

Chinese Medical Journal

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Correlation of parameters on preoperative CT images with intra-articular soft-tissue injuries in acute tibial plateau fractures: A review of 132 patients receiving ARIF

Cited by 30 publications

References 32 publications

The “Diagonal” Lesion: A New Type of Combined Injury Pattern Involving the Impingement Fracture of Anteromedial Tibial Plateau and the Injury of Posterior Cruciate Ligament and Posterolateral Corner

The “Diagonal” Lesion: A New Type of Combined Injury Pattern Involving the Impingement Fracture of Anteromedial Tibial Plateau and the Injury of Posterior Cruciate Ligament and Posterolateral Corner

Correlation Between CT Images of Lateral Plateau and Lateral Meniscus Injuries in Patients With Schatzker II Tibial Plateau Fractures：A Retrospective Study

New Developments in Treatments of Tibial Plateau Fractures

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