Intra-articular tibial plateau fracture characteristics according to the “Ten segment classification”

Krause, Matthias; Preiß, Achim; Müller, G.; Madert, J.; Fehske, Kai; Neumann, Mirjam; Domnick, Christoph; Raschke, Michael J.; Südkamp, Norbert P.; Frosch, Karl‐Heinz

doi:10.1016/j.injury.2016.09.014

Cited by 157 publications

(125 citation statements)

References 35 publications

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“…However, recent CT-oriented classification systems provide more detailed information pertaining to the fracture morphology, degree of joint depression and appropriate surgical approach. 4,5 Luo et al 4 recently described a CT-based three-column model to evaluate tibial plateau fractures and clinical decision-making (Fig. 1).…”

Section: Mechanism Of Traumamentioning

confidence: 99%

“…Krause et al 5 investigated fracture patterns from a total of 242 patients with 246 affected knees and suggested ‘ten segment’ mapping of the tibial plateau (Fig. 2).…”

Section: Mechanism Of Traumamentioning

confidence: 99%

“…Unicondylar lateral tibial plateau fractures were most common (88.8%), whereas the medial plateau was only involved in 10% of unicompartmental or extended lateral type-B fractures. 5 These unicompartmental medial plateau fractures are mainly associated with low-energy injury mechanisms. A possible reason for the relatively increased involvement of the lateral tibial plateau (Fig.…”

Section: Mechanism Of Traumamentioning

confidence: 99%

“…5 In a prospective study in an alpine skiing region (Grenoble, France), Morin et al 8 detected unicompartmental posteromedial Moore I fractures in 13% of all injured alpine skiers, who received surgical treatment for intra-articular tibial plateau fractures. However, in the well-mineralised tibial head, fractures of the medial compartment appeared more often in multi-part tibial-head dislocation-type injuries.…”

Section: Mechanism Of Traumamentioning

confidence: 99%

“…Although anteromedial partial proximal tibial fractures are rare, 5 this approach may help to reduce and fix posterior or lateral partial tibial head fractures using retrograde K-wires or cannulated screws. 8 In addition to the anteromedial tibial LCP and medial LISS-plate, the locked tomofix plate may be useful in selected cases.…”

Section: Treatment Options: Approaches and Techniquesmentioning

confidence: 99%

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Partial proximal tibia fractures

2017

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Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component.High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density.Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient.Non-operative treatment may be considered for non-displaced intra-articular fractures of the lateral tibial condyle. Intra-articular joint displacement ⩾ 2 mm, open fractures or fractures of the medial condyle should be reduced and fixed operatively. Autologous, allogenic and synthetic bone substitutes can be used to fill bone defects.A variety of minimally invasive approaches, temporary osteotomies and novel techniques (e.g. arthroscopically assisted reduction or ‘jail-type’ screw osteosynthesis) offer a range of choices for the individual and are potentially less invasive treatments.Rehabilitation protocols should be carefully planned according to the degree of stability achieved by internal fixation, bone mineral density and other patient-specific factors (age, compliance, mobility). To avoid stiffness, early functional mobilisation plays a major role in rehabilitation. In the elderly, low-energy trauma and impression fractures are indicators for the further screening and treatment of osteoporosis.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160067. Originally published online at www.efortopenreviews.org

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Section: Mechanism Of Traumamentioning

confidence: 99%

“…Krause et al 5 investigated fracture patterns from a total of 242 patients with 246 affected knees and suggested ‘ten segment’ mapping of the tibial plateau (Fig. 2).…”

Section: Mechanism Of Traumamentioning

confidence: 99%

Section: Mechanism Of Traumamentioning

confidence: 99%

Section: Mechanism Of Traumamentioning

confidence: 99%

Section: Treatment Options: Approaches and Techniquesmentioning

confidence: 99%

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