Radiographic Prediction of Soft Tissue Injury Associated With Tibial Plateau Fractures: The Direction of Articular Depression Matters


This investigation aimed to evaluate the impact of coronal articular fragment displacement of Schatzker type II tibial plateau fractures on concomitant soft tissue knee injuries. One hundred consecutively treated patients were included. Depression depth and coronal articular fragment displacement were measured radiographically, and medial collateral ligament (MCL) and lateral meniscus (LM) injury, and pain and range of motion (ROM) on final follow up, were recorded. Multivariable regression was then performed. Coronal articular fragment displacement was medially and laterally hinged in 74% and 26% of patients, respectively. MCL injuries were significantly higher in the lateral hinge group (odds ratio [OR]: 3.25; confidence interval [CI]: 1.07 to 9.84; p = 0.03). No difference was found in LM injury incidence and amount of articular depression between groups. At final follow-up, average pain and ROM was similar between groups. Findings demonstrate a significant correlation between laterally hinged articular depression in Schatzker II tibial plateau fractures and concomitant MCL injury. (Journal of Surgical Orthopaedic Advances 32(4):270-275, 2023)

Key words: tibial plateau, articular depression, Schatzker II, medial collateral ligament, lateral meniscus

Matthew P. Lunati, MD; Jesse Seilern und Aspang, MD; J’Lynn L. Baker, BS; Jacob M. Wilson, MD; and Thomas J. Moore, Jr., MD