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Are Schatzker and AO classifications accurate enough to classify tibial plateau fractures in alpine skiers?

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Abstract

Purpose

The aims of this study were (1) to collect prospectively all tibial plateau fractures admitted to our department, over two ski seasons, and to classify them according to the Schatzker and AO classifications; (2) to assess if these classifications are accurate enough to include all types of fractures; and (3) to compare theses fractures with the series found in the literature, which included very few or no skiing accidents.

Methods

During the 2016-2017 and 2017-2018 ski seasons, we prospectively included 116 tibial plateau fractures caused by downhill skiing accidents. All patients underwent standard X-rays and 2D and 3D CT scans. The fractures were classified according to the AO and Schatzker revisited classifications.

Results

The full series consisted of 56 males (48%) and 60 females (52%), aged 49 ± 16 years (18-77). There were 60 type B (52%) and 56 type C fractures (48%) for AO classification and 45.5% types I, II and III and 54.5% types IV, V and VI for Schatzker classification. Thirty-five frontal fractures (30%) were not differentiated under the AO classification and, likewise, associated tibial spine fractures (28.5%) were not differentiated in the Schatzker classification. We were also unable to classify anterior tibial tuberosity fractures (14.5%) and fibula head fractures (8%). The anatomo-pathological types were not so different from road traffic accidents.

Conclusion

Contrary to our hypothesis, the anatomical-pathological damage in tibial plateau fractures resulting from downhill skiing accidents was barely any different from those found in road traffic accidents. However, despite progress in classifications with the emergence of 3D CT scans, it is still not always possible to categorise all fractures within a given classification.

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Authors and Affiliations

  1. Department of Osteoarthritis and Sport Surgery, Grenoble-Alpes CHU, South Teaching Hospital, Kimberley Avenue, BP 338 38434, Échirolles Cedex, France

    Dominique Saragaglia, J. C. Giunta, J. Gaillot, B. Rubens-Duval & R. Pailhé

  2. Grenoble-Alpes Medical Faculty, Service de Chirurgie Orthopédique, CHU Grenoble-Alpes site de Voiron, Route des Gorges, 38500, Voiron, France

    Dominique Saragaglia

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  1. Dominique Saragaglia
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  2. J. C. Giunta
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  3. J. Gaillot
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  4. B. Rubens-Duval
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  5. R. Pailhé
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Contributions

- DS: construction, methodology and writing of the article

- JCG: data collection

- JG: translation of the article

- BRD: literature analysis

- RP: proofreading of the article

Corresponding author

Correspondence to Dominique Saragaglia.

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Saragaglia, D., Giunta, J.C., Gaillot, J. et al. Are Schatzker and AO classifications accurate enough to classify tibial plateau fractures in alpine skiers?. International Orthopaedics (SICOT) 45, 1863–1869 (2021). https://doi.org/10.1007/s00264-021-04993-8

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  • DOI: https://doi.org/10.1007/s00264-021-04993-8

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