Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification"
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Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification". / Krause, Matthias; Preiss, Achim; Müller, Gunnar; Madert, Jürgen; Fehske, Kai; Neumann, Mirjam V; Domnick, Christoph; Raschke, Michael; Südkamp, Norbert; Frosch, Karl-Heinz.
In: INJURY, Vol. 47, No. 11, 11.2016, p. 2551-2557.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification"
AU - Krause, Matthias
AU - Preiss, Achim
AU - Müller, Gunnar
AU - Madert, Jürgen
AU - Fehske, Kai
AU - Neumann, Mirjam V
AU - Domnick, Christoph
AU - Raschke, Michael
AU - Südkamp, Norbert
AU - Frosch, Karl-Heinz
N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.
PY - 2016/11
Y1 - 2016/11
N2 - BACKGROUND: Currently existing classifications of tibial plateau fractures do not help to guide surgical strategy. Recently, a segment-based mapping of the tibial plateau has been introduced in order to address fractures with a fracture-specific surgical approach. The goal of the present study was to analyze incidence and fracture specifics according to a new 10-segment classification of the tibial plateau.METHODS: A total of 242 patients with 246 affected knees were included (124 females, 118 males, mean age 51.9±16.1years). Fractures were classified according to the OTA/AO classification. 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.RESULTS: 161 Patients suffered an OTA/AO type 41-B and 85 patients an OTA/AO type 41-C tibial plateau fracture. 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. 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. 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. Every second type C fracture showed an unique fracture line and zone of comminution. The tibial spine was typically involved (89.4%). 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 most frequently affected segments were the postero-latero-central (85.9%), postero-central (84.7%), and antero-latero-central (78.8%) segment.CONCLUSION: Posterior segments were the most frequently affected in OTA/AO type B and C fractures. 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. Also, low-energy trauma was identified as an important cause for tibial plateau fractures.
AB - BACKGROUND: Currently existing classifications of tibial plateau fractures do not help to guide surgical strategy. Recently, a segment-based mapping of the tibial plateau has been introduced in order to address fractures with a fracture-specific surgical approach. The goal of the present study was to analyze incidence and fracture specifics according to a new 10-segment classification of the tibial plateau.METHODS: A total of 242 patients with 246 affected knees were included (124 females, 118 males, mean age 51.9±16.1years). Fractures were classified according to the OTA/AO classification. 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.RESULTS: 161 Patients suffered an OTA/AO type 41-B and 85 patients an OTA/AO type 41-C tibial plateau fracture. 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. 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. 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. Every second type C fracture showed an unique fracture line and zone of comminution. The tibial spine was typically involved (89.4%). 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 most frequently affected segments were the postero-latero-central (85.9%), postero-central (84.7%), and antero-latero-central (78.8%) segment.CONCLUSION: Posterior segments were the most frequently affected in OTA/AO type B and C fractures. 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. Also, low-energy trauma was identified as an important cause for tibial plateau fractures.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Fracture Fixation, Internal
KW - Fractures, Comminuted
KW - Humans
KW - Imaging, Three-Dimensional
KW - Incidence
KW - Intra-Articular Fractures
KW - Knee Injuries
KW - Male
KW - Middle Aged
KW - Reproducibility of Results
KW - Retrospective Studies
KW - Tibial Fractures
KW - Tomography, X-Ray Computed
KW - Young Adult
KW - Journal Article
U2 - 10.1016/j.injury.2016.09.014
DO - 10.1016/j.injury.2016.09.014
M3 - SCORING: Journal article
C2 - 27616003
VL - 47
SP - 2551
EP - 2557
JO - INJURY
JF - INJURY
SN - 0020-1383
IS - 11
ER -
