Tibial plateau fracture classification: Difference between revisions

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{{Tibial plateau fracture}}
{{Tibial plateau fracture}}


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==Overview==
==Overview==
There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO classification.
There are multiple [[Classification|classifications]] available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO [[classification]].


==Classification==
==Classification==
There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO/OTA classification.<ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref>
There are multiple [[Classification|classifications]] available for tibial plateau fracture. The most common [[classification]] systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO/OTA [[classification]].<ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref>


===Schatzker Classification===
===Schatzker Classification===
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{| class="wikitable"
{| class="wikitable"
! colspan="2" |Schatzker Classification
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Schatzker Classification
|-
|-
|Type I
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
|Lateral split fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral split [[Bone fracture|fracture]]
|-
|-
|Type II
| style="background: #4479BA; color: #FFFFFF; text-align: center;" | Type II
|Lateral Split-depressed fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral Split-depressed [[Bone fracture|fracture]]
|-
|-
|Type III
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
|Lateral Pure depression fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral Pure depression [[Bone fracture|fracture]]
|-
|-
|Type IV
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type IV
|Medial plateau fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Medial plateau [[Bone fracture|fracture]]
|-
|-
|Type V
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type V
|Bicondylar fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bicondylar [[Bone fracture|fracture]]
|-
|-
|Type VI
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type VI
|Metaphyseal-diaphyseal disassociation
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Metaphyseal-diaphyseal [[Dissociation (chemistry)|dissociation]]
|}
|}


===Hohl and Moore Classification===
===Hohl and Moore Classification===
* Hohl and Moore classification of tibial plateau fracture is useful for fracture dislocation, fracture patterns that cannot be classified by Schatzker classification and fractures associated with knee instability.<ref>Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts CM, editor. Surgery of the musculoskeletal system. 2nd ed., New York: Churchill Livingstone; 1990. </ref>
* Hohl and Moore [[classification]] of tibial plateau fracture is useful for [[fracture]] [[dislocation]], [[fracture]] patterns that cannot be classified by Schatzker [[classification]] and [[fractures]] associated with [[Instability|knee instability]].<ref>Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts CM, editor. Surgery of the musculoskeletal system. 2nd ed., New York: Churchill Livingstone; 1990. </ref>


{| class="wikitable"
{| class="wikitable"
! colspan="2" |Hohl and Moore Classification
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hohl and Moore Classification
|-
|-
|Type I
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type I
|Coronal split fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Coronal split [[fracture]]
|-
|-
|Type II
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type II
|Entire condylar fracture  
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Entire condylar [[Bone fracture|fracture]]
|-
|-
|Type III
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type III
|Rim avulsion fracture of lateral plateau
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Rim avulsion [[Bone fracture|fracture]] of lateral plateau
|-
|-
|Type IV
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type IV
|Rim compression fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Rim compression [[Bone fracture|fracture]]
|-
|-
|Type V
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type V
|Four-part fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Four-part [[Bone fracture|fracture]]
|}
|}


===Luo's Three Column Classification===
===Luo's Three Column Classification===
* Luo's classified tibial plateau fracture  based on computed tomography ‘‘three column fixation’’ concept which aided in  column-specific fixation technique.<ref name="pmid20881634">{{cite journal| author=Luo CF, Sun H, Zhang B, Zeng BF| title=Three-column fixation for complex tibial plateau fractures. | journal=J Orthop Trauma | year= 2010 | volume= 24 | issue= 11 | pages= 683-92 | pmid=20881634 | doi=10.1097/BOT.0b013e3181d436f3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20881634  }} </ref>
* Luo's [[Classification|classified]] tibial plateau fracture  based on [[computed tomography]] ‘‘three column fixation’’ concept which aided in  column-specific [[fixation]] technique.<ref name="pmid20881634">{{cite journal| author=Luo CF, Sun H, Zhang B, Zeng BF| title=Three-column fixation for complex tibial plateau fractures. | journal=J Orthop Trauma | year= 2010 | volume= 24 | issue= 11 | pages= 683-92 | pmid=20881634 | doi=10.1097/BOT.0b013e3181d436f3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20881634  }} </ref>


{| class="wikitable"
{| class="wikitable"
! colspan="2" |Luo's Three Column Classification
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Luo's Three Column Classification
|-
|-
|Zero-column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Zero-column fracture
|Pure articular depression
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pure articular depression
|-
|-
|1 Column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |1 Column fracture
|Lateral column fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral column [[Bone fracture|fracture]]
|-
|-
|2 Column fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |2 Column fracture
|Lateral and posterior column fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Lateral and posterior column [[Bone fracture|fracture]]
|-
|-
|3 Column  fracture
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |3 Column  fracture
|Bicondylar fracture dividing into three fragments
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bicondylar [[Bone fracture|fracture]] dividing into three fragments
|}
|}
*
===OTA System===
===OTA System===
*AO/ASIF  classification is also a widely accepted classification.<ref>ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.</ref>  
*AO/ASIF  [[classification]] is also a widely accepted [[classification]].<ref>ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.</ref>  
*Proximal tibia is given the number 41 based on the classification.
*Proximal [[tibia]] is given the number 41 based on the classification.
*It is further subdivided as:
*It is further subdivided as:


{| class="wikitable"
{| class="wikitable"
! colspan="3" |OTA System
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |OTA System
|-
|-
| rowspan="4" |A
| rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |A
| colspan="2" |Extra-articular fractures
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Extra-articular [[Bone fracture|fractures]]
|-
|-
|A1
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |A1
|Avulsion
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Avulsion
|-
|-
|A2
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |A2
|Metaphyseal simple
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Metaphyseal simple
|-
|-
|A3
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |A3
|Metaphyseal multifragmentary
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Metaphyseal multifragmentary
|-
|-
| rowspan="4" |B
| rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |B
| colspan="2" |Partial articular fractures
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Partial articular [[Bone fracture|fractures]]
|-
|-
|B1
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |B1
|Pure split
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pure split
|-
|-
|B2
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |B2
|Pure depression
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Pure depression
|-
|-
|B3
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |B3
|Split depression
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Split depression
|-
|-
| rowspan="4" |C
| rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |C
| colspan="2" |Complete articular fractures
| colspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |Complete articular [[Bone fracture|fractures]]
|-
|-
|C1
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |C1
|Articular simple + [[metaphyseal]] simple
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Articular]] simple + [[metaphyseal]] simple
|-
|-
|C2
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |C2
|Articular simple, [[metaphyseal]] multifragmentary
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Articular]] simple, [[metaphyseal]] multifragmentary
|-
|-
|C3
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |C3
|Articular multifragmentary
| style="background: #F5F5F5; padding: 5px; text-align: center;" |[[Articular]] multifragmentary
|}
|}


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[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Orthopedic surgery]]
[[Category:Orthopedic surgery]]
[[Category:Primary care]]
[[Category:Fractures]]
[[Category:Fractures]]
[[Category:Bone fractures]]
[[Category:Bone fractures]]

Latest revision as of 00:25, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO classification.

Classification

There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo's three column concept and AO/OTA classification.[1][2]

Schatzker Classification

Schatzker Classification of tibial plateau fracture. Source: Case courtesy of Case courtesy of Dr Sachintha Hapugoda, Radiopaedia.org, rID: 51744
  • Schatzker classification is the most commonly used classification for tibial plateau fracture.[3]
Schatzker Classification
Type I Lateral split fracture
Type II Lateral Split-depressed fracture
Type III Lateral Pure depression fracture
Type IV Medial plateau fracture
Type V Bicondylar fracture
Type VI Metaphyseal-diaphyseal dissociation

Hohl and Moore Classification

Hohl and Moore Classification
Type I Coronal split fracture
Type II Entire condylar fracture
Type III Rim avulsion fracture of lateral plateau
Type IV Rim compression fracture
Type V Four-part fracture

Luo's Three Column Classification

Luo's Three Column Classification
Zero-column fracture Pure articular depression
1 Column fracture Lateral column fracture
2 Column fracture Lateral and posterior column fracture
3 Column fracture Bicondylar fracture dividing into three fragments

OTA System

OTA System
A Extra-articular fractures
A1 Avulsion
A2 Metaphyseal simple
A3 Metaphyseal multifragmentary
B Partial articular fractures
B1 Pure split
B2 Pure depression
B3 Split depression
C Complete articular fractures
C1 Articular simple + metaphyseal simple
C2 Articular simple, metaphyseal multifragmentary
C3 Articular multifragmentary

References

  1. ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
  2. ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
  3. ↑ Schatzker J, McBroom R, Bruce D (1979). "The tibial plateau fracture. The Toronto experience 1968--1975". Clin Orthop Relat Res (138): 94–104. PMID 445923.
  4. ↑ Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts CM, editor. Surgery of the musculoskeletal system. 2nd ed., New York: Churchill Livingstone; 1990.
  5. ↑ Luo CF, Sun H, Zhang B, Zeng BF (2010). "Three-column fixation for complex tibial plateau fractures". J Orthop Trauma. 24 (11): 683–92. doi:10.1097/BOT.0b013e3181d436f3. PMID 20881634.
  6. ↑ ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.

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