The prevalence of soft tissue injuries in operative Schatzker type IV tibial plateau fractures

Yan, Bingshan; Sun, Jianwei; Yin, Weiqiang

doi:10.1007/s00402-020-03533-0

Cited by 24 publications

(28 citation statements)

References 23 publications

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“…Schatzker type IV fractures are considered as high-energy injuries and associated soft tissue injuries are frequent. 4,5,14 To gain further insight on this type of injury, Schatzker type IV fracture has been subtyped by many scholars. Wahlquist et al 14 found that the more lateral the fracture line moves, the greater the risk of these associated soft tissue complications.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

et al. 2022

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Introduction Tibial plateau fractures are often accompanied with ligamental and meniscal injuries. Among which, the combined existence of Schatzker type IV fracture with anterior cruciate ligament (ACL) avulsion has been reported rarely. The purpose of this study was to determine the injury mechanism of Schatzker type IV fracture with ACL avulsion based on Mimics software. Methods Ninety-nine Schatzker type IV tibial plateau fractures were retrospectively analyzed by quantitative three-dimensional measurements. ACL avulsions were diagnosed through the data of computed tomography and magnetic resonance imaging. We simulated the knee posture when an injury occurred and defined different injury patterns. The chi-square test was used for determining the main mechanism which causes Schatzker type IV fractures associated with ACL avulsions. Results There were more ACL avulsions and more displaced ACL avulsions associated with the knee in flexion in the setting of Schatzker type IV fracture (p < 0.05). More ACL avulsions were found in the injury pattern of flexion-valgus than the other injury patterns of the same level (p < 0.05). The rotation of the tibial showed no significant difference in producing ACL avulsion fractures. Conclusion This study found that a flexed knee at the occurrence of a Schatzker type IV tibial plateau fracture is a high-risk factor for causing associated ACL avulsion and producing more displaced avulsions. Flexion-valgus pattern was the main cause of Schatzker type IV fractures associated with ACL avulsions. The findings will help orthopedists understand the injury mechanism and enhance their awareness of such injuries to avoid unfavorable prognosis.

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Section: Discussionmentioning

confidence: 99%

The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

et al. 2022

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“…We calculated the lower incidence of TMLs that required surgical intervention and contrasted it to 92.2%-99% in the previous study of Schatzker II fracture of tibial plateau and the recent research (71 Lateral, 15 medial/132 cases) in acute TPFs[ 7 , 13 ]. There are no statistically different results according to the severity of fracture, including Schatzker IV, which is consistent with previous literature[ 14 , 15 ]. Our further study, however, shows that red-red zone, longitude tear (bucket handle) pattern of TMLs demonstrated different results in different condylar number groups.…”

Section: Discussionmentioning

confidence: 99%

Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients

Chen¹,

Chen²,

Liu³

et al. 2021

WJCC

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“…Considering the increasing clinical interest in ME, measurements need to be simple, reliable and cost-effective. In one study, 63% of patients with Schatzker type IV tibial plateau fractures had concomitant lateral meniscal injuries diagnosed by MRI [32]. The authors assumed that the incidence of true lateral meniscal injuries was overestimated by MRI [32].…”

Section: Discussionmentioning

confidence: 99%

“…In one study, 63% of patients with Schatzker type IV tibial plateau fractures had concomitant lateral meniscal injuries diagnosed by MRI [32]. The authors assumed that the incidence of true lateral meniscal injuries was overestimated by MRI [32]. Therefore, US-based assessment of lateral ME may be used to evaluate the functional integrity of the lateral meniscus in Schatzker Type IV fractures to facilitate treatment decision-making regarding the meniscus.…”

Section: Discussionmentioning

confidence: 99%

Sonographic evaluation of lateral meniscal extrusion: implementation and validation

Winkler

Csapo

Wierer

et al. 2020

Arch Orthop Trauma Surg

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Introduction Meniscal extrusion (ME) is an important indicator of and prognostic factor for various knee pathologies. To date, no standardized protocol for the ultrasound-based examination of lateral ME exists. The purpose of the present study was to test the reliability and validity of lateral ME measurements using a standardized ultrasound-based examination protocol. Materials and Methods A group consisting of 11 healthy volunteers (Group I, male and female, 18–45 years) as well as a group of 10 consecutive patients who had undergone all-inside lateral meniscal radial tear repair were included (Group II, male and female, 23–43 years). Lateral ME, the main outcome parameter, was measured by ultrasound (US; both groups) and magnetic resonance imaging (MRI; Group II only). Both knees of all subjects were examined in an unloaded state and under axial compression of the knee (50% of body weight). Repeated measurements obtained in Group I by 2 observers were used for reliability testing, and the validity of US was assessed through comparison with MRI data (Group II). Results A total of 66 US images of Group I, obtained by each observer, were analyzed for reliability testing. Forty US and MR images of Group II were assessed for validation. Results showed good interrater (ICC = 0.904) and excellent intrarater (ICC = 0.942) reliability of US-based measurements of lateral ME. Agreement with MRI results was poor (ICC = 0.439), with US systematically overestimating results by 1.1 mm on average. Conclusions Ultrasound is a reliable, quick and cost-effective technique for lateral ME measurement, but results are not readily comparable with MRI. Trial registration The study was registered in the European Union Clinical Trials Register (EudraCT-Number: 2017-005037-24).

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The prevalence of soft tissue injuries in operative Schatzker type IV tibial plateau fractures

Cited by 24 publications

References 23 publications

The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

The Relationship between the Injury Mechanism and the Incidence of ACL Avulsions in Schatzker Type IV Tibial Plateau Fractures: A 3D Quantitative Analysis Based on Mimics Software

Is traumatic meniscal lesion associated with acute fracture morphology changes of tibia plateau? A series of arthroscopic analysis of 67 patients

Sonographic evaluation of lateral meniscal extrusion: implementation and validation

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