Incidence of posterolateral tibia plateau fractures and concomitant injuries in Chinese patients who underwent an anterior cruciate ligament reconstruction

Abstract

Objective The purpose of the present study was to report the incidence and classify the morphological subtypes of posterolateral tibial plateau fractures accompanying anterior cruciate ligament (ACL) tears in an East China population, as well as to evaluate the implications of such injuries on the functional recovery following ACL reconstruction. Methods 488 cases of patients treated for ACL rupture between January 2016 and June 2020 were retrospectively reviewed, and their posterolateral tibial plateau fractures were classified based on MRI assessment. Functional outcomes were evaluated at a two-year postoperative follow-up using a range of validated scoring systems. Results The study identified a high incidence of posterolateral tibial plateau fractures (41.6%) among ACL injury cases, with type ⅢA and ⅢB fractures occurring more frequently. Patients with high-grade fractures experienced significantly lower functional recovery than those with low-grade injuries. Major findings included noncontact mechanism predominance in ACL injuries, a higher occurrence rate of type ⅢA and ⅢB fractures among older females, and a substantial association with meniscal and medial collateral ligament tears. Conclusions The incidence and distinct morphological classification of posterolateral tibial plateau fractures are clinically significant in ACL injury cases. The higher grade posterotibial plateau fractures are associated with worse functional outcomes in patients undergoing an ACLR.