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Morphological characteristics of Schatzker type IV tibial plateau fractures: a computer tomography based study

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Abstract

Purpose

The objective of this study was to evaluate the morphological characteristics of Schatzker type IV tibial plateau fractures.

Methods

A retrospective analysis of radiographic and computed tomographic data of tibial plateau Schatzker type IV fractures from January 2010 to December 2011 was conducted in a level 1 trauma centre. The medial fracture angle (MFA), surface area percentage (SAP), and medial fracture height (MFH) were measured on CT images using the Picture Archiving and Communication System.

Results

Based on the location of fracture and the MFA, 75 cases of Schatzker type IV fracture were divided into three subtypes: anteromedial fracture (seven cases, 9.3 %), total medial plateau fracture (36 cases, 48 %), and posteromedial fracture (32 cases, 42.7 %). The anteromedial fracture was located on the anterior part of the medial plateau, the average MFA was positive 47.5°, the SAP was 38.3 % and the MFH was 41.6 mm. The total medial plateau fracture usually involved the entire medial plateau, the mean value of MFA was 81.2°, the SAP was 53.9 % and the MFH was 64.0 mm. The posteromedial fracture was located on the posterior part of the medial plateau, the MFA was negative 42.5°, the SAP was 32.4 % and the MFH was 44.8 mm.

Conclusion

The direction and location of Schatzker type IV fractures are highly variable. Proper operative approach and fixation method should be selected based on the morphological characteristics of individual medial plateau fractures.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University, No. 600, Yishan Road, Shanghai, 200233, People’s Republic of China

    Guang Yang, Yi Zhu & Congfeng Luo

  2. Trauma & Orthopaedic Department, St. George’s Hospital, London, UK

    Sven Putnis

Authors
  1. Guang Yang
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  2. Yi Zhu
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  3. Congfeng Luo
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  4. Sven Putnis
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Corresponding author

Correspondence to Congfeng Luo.

Additional information

Guang Yang and Yi Zhu contributed equally to this study.

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Yang, G., Zhu, Y., Luo, C. et al. Morphological characteristics of Schatzker type IV tibial plateau fractures: a computer tomography based study. International Orthopaedics (SICOT) 36, 2355–2360 (2012). https://doi.org/10.1007/s00264-012-1646-y

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  • DOI: https://doi.org/10.1007/s00264-012-1646-y

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