Tibial plateau fracture classification

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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 classification.

Schatzker Classification

  • Schatzker classifiis the most commonly used classification for tibial plateau fracture.
Schatzker Classification
I Extra-articular
II Extra-articular with ulnar fracture
III Intra-articular into radiocarpal joint
IV Intra-articular into radiocarpal joint with ulnar fracture
V Intra-articular into radioulnar joint
VI Intra-articular into radioulnar joint with ulnar fracture

Melone Classification

Melone Classification
I Undisplaced, no or minimal comminution
II Die punch fracture with moderate to severe displacement
A Reducible
B Irreducible
III Spike fragment present
IV Wide separation of intra-articular fragments
V Explosion fracture with severe comminution, transverse split and rotational displacement
Schatzker Classification of tibial plateau fracture. Source: Case courtesy of Case courtesy of Dr Sachintha Hapugoda, Radiopaedia.org, rID: 51744

Hohl and Moore Classification

Fernández Classification
Type 1 Bending fracture of metaphysis
Type 2 Shearing fracture of joint surface
Type 3 Compression fracture of joint surface
Type 4 Avulsion fractures or radiocarpal fracture-dislocation
Type 5 Combined fractures associated with high high-velocity injuries

Universal Classification

Universal Classification
Type 1 Extra-articular fracture, without deviation
Type 2 Extra-articular fracture, with deviation
2A Reducible and stable
2B Reducible and unstable
2C Irreducible
Type 3 Intra-articular fracture, without deviation
Type 4 Intra-articular fracture, with deviation
4A Reducible and stable
4B Reducible and unstable
4C Irreducible

OTA System

  • AO/ASIF classification is the widely accepted classification.
  • Radius is given the number 21 based on the classification.[5]
  • It is further subdivided as:
OTA System
A Extra-articular fractures
A1 Ulnar fracture, radius intact
A2 Radius fracture, simple and impacted
A3 Radius fracture, multifragmentary
B Partial articular fractures
B1 Radius fracture, sagittal
B2 Radius fracture, frontal, dorsal rim
B3 Radius fracture, frontal, volar rim
C Complete articular fractures
C1 Articular simple + metaphyseal simple
C2 Articular simple, metaphyseal multifragmentary
C3 Articular multifragmentary


References

  1. Melone CP (1993). "Distal radius fractures: patterns of articular fragmentation". Orthop Clin North Am. 24 (2): 239–53. PMID 8479722.
  2. Melone CP (1984). "Articular fractures of the distal radius". Orthop Clin North Am. 15 (2): 217–36. PMID 6728444.
  3. Fernandez DL (2001). "Distal radius fracture: the rationale of a classification". Chir Main. 20 (6): 411–25. PMID 11778328.
  4. Cooney WP (1993). "Fractures of the distal radius. A modern treatment-based classification". Orthop Clin North Am. 24 (2): 211–6. PMID 8479719.
  5. Arealis G, Galanopoulos I, Nikolaou VS, Lacon A, Ashwood N, Kitsis C (2014). "Does the CT improve inter- and intra-observer agreement for the AO, Fernandez and Universal classification systems for distal radius fractures?". Injury. 45 (10): 1579–84. doi:10.1016/j.injury.2014.06.017. PMID 25042062.

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