![]() ![]() A weak association was found between increasing frequency of LCL and ACL lesions and an increase in fracture type according to Schatzker's classification. The proportions of soft-tissue lesions were as follows: medial collateral ligament 20.7%, lateral collateral ligament 22.9%, anterior cruciate ligament 36.8%, posterior cruciate ligament 14.8%, lateral meniscus 48.9%, and medial meniscus 24.5%. The proportion of total soft-tissue lesions was 93.0%. Of these, 18 met the eligibility criteria and included a total of 877 patients. This systematic review aimed to determine the frequency of soft-tissue lesions in TPFs, the association between fracture type and soft-tissue lesions, and the types of cases for which MRI is indicated.Ī systematic review of the literature was based on articles located in PubMed/MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL), supplemented by searching the included articles' reference lists and the ePublication lists of leading orthopedic and trauma journals.Ī total of 1138 studies were retrieved. To date, no literature exists that clearly states the indications for preoperative MRI. Magnetic resonance imaging (MRI) is not routinely performed. Preoperative planning is primarily based on conventional X-ray and computed tomography (CT), which are unsuitable for diagnosing soft-tissue lesions. Sub-optimal treatment can result in poor knee function and osteoarthritis. ![]() Also, low-energy trauma was identified as an important cause for tibial plateau fractures.The outcome of a tibial plateau fracture (TPF) depends on the fracture reduction achieved and the extent of soft-tissue lesions, including lesions in the ligaments, cartilage, and menisci. Acknowledging the restricted visibility of posterior segments, whose reduction and fixation is crucial for long-term success, our findings implicate the use of posterior approaches more often in the treatment of tibial plateau fractures. Posterior segments were the most frequently affected in OTA/AO type B and C fractures. The most frequently affected segments were the postero-latero-central (85.9%), postero-central (84.7%), and antero-latero-central (78.8%) segment. A typical fracture pattern of high-energy trauma demonstrated a zone of comminution of the lateral plateau and a split fracture in the medial plateau. The tibial spine was typically involved (89.4%). ![]() Every second type C fracture showed an unique fracture line and zone of comminution. In type B fractures, the postero-latero-lateral (65.2%), the antero-latero-lateral (64.6%) and the antero-latero-central (60.9%) segment were most frequently affected. In 34% of the patients with affection of the medial tibial plateau, a fracture comminution, primarily due to low-energy trauma (p< 0.001), was observed. Females had an almost seven times higher risk to suffer a fracture due to low-energy trauma (OR 6.91, 95% CI (3.52, 13.54), p< 0.001) than males. Fracture pattern was analyzed with respect to a 10-segment classification based on CT imaging of the proximal tibial plateau 3cm below the articular surface.ġ61 Patients suffered an OTA/AO type 41-B and 85 patients an OTA/AO type 41-C tibial plateau fracture. Fractures were classified according to the OTA/AO classification. The goal of the present study was to analyze incidence and fracture specifics according to a new 10-segment classification of the tibial plateau.Ī total of 242 patients with 246 affected knees were included (124 females, 118 males, mean age 51.9☑6.1years). Recently, a segment-based mapping of the tibial plateau has been introduced in order to address fractures with a fracture-specific surgical approach. Currently existing classifications of tibial plateau fractures do not help to guide surgical strategy. ![]()
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