Tibial plateau fracture classification: Difference between revisions

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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 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 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 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 fracture
|-
|-
|Type V
| style="background: #4479BA; color: #FFFFFF; text-align: center;" |Type V
|Bicondylar fracture
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Bicondylar 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 disassociation  
|}
|}


Line 44: Line 44:


{| 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 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 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 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 fracture
|}
|}


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{| 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 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 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 fracture dividing into three fragments
|}
|}
*  
*  
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{| 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 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 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 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
|}
|}


Revision as of 21:11, 2 February 2019

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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 disassociation

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.[4]
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 classified tibial plateau fracture based on computed tomography ‘‘three column fixation’’ concept which aided in column-specific fixation technique.[5]
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

  • AO/ASIF classification is also a widely accepted classification.[6]
  • Proximal tibia is given the number 41 based on the classification.
  • It is further subdivided as:
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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