J Knee Surg 2016; 29(06): 451-457
DOI: 10.1055/s-0036-1581132
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Incidence of Soft-Tissue Injuries in Patients with Posterolateral Tibial Plateau Fractures: A Retrospective Review from 2009 to 2014

Yanqing Wang
1   Department of Orthopedic Surgery, Tianjin Union Medical Center, Tianjin, China
,
Fujiang Cao
2   Department of Orthopedic Surgery, Tianjin Medical University General Hospital, Tianjin, Tianjin, China
,
Minghui Liu
1   Department of Orthopedic Surgery, Tianjin Union Medical Center, Tianjin, China
,
Jiantao Wang
1   Department of Orthopedic Surgery, Tianjin Union Medical Center, Tianjin, China
,
Shikong Jia
1   Department of Orthopedic Surgery, Tianjin Union Medical Center, Tianjin, China
› Author Affiliations
Further Information

Publication History

26 January 2016

21 February 2016

Publication Date:
16 May 2016 (online)

Abstract

Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures.

Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data.

Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%.

Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures.

 
  • References

  • 1 Xiang G, Zhi-Jun P, Qiang Z, Hang L. Morphological characteristics of posterolateral articular fragments in tibial plateau fractures. Orthopedics 2013; 36 (10) e1256-e1261
  • 2 Zhu Y, Meili S, Dong MJ , et al. Pathoanatomy and incidence of the posterolateral fractures in bicondylar tibial plateau fractures: a clinical computed tomography-based measurement and the associated biomechanical model simulation. Arch Orthop Trauma Surg 2014; 134 (10) 1369-1380
  • 3 Frosch KH, Balcarek P, Walde T, Stürmer KM. A new posterolateral approach without fibula osteotomy for the treatment of tibial plateau fractures. J Orthop Trauma 2010; 24 (8) 515-520
  • 4 Yu B, Han K, Zhan C, Zhang C, Ma H, Su J. Fibular head osteotomy: a new approach for the treatment of lateral or posterolateral tibial plateau fractures. Knee 2010; 17 (5) 313-318
  • 5 Gardner MJ, Yacoubian S, Geller D , et al. The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients. J Orthop Trauma 2005; 19 (2) 79-84
  • 6 Stallenberg B, Gevenois PA, Sintzoff Jr SA, Matos C, Andrianne Y, Struyven J. Fracture of the posterior aspect of the lateral tibial plateau: radiographic sign of anterior cruciate ligament tear. Radiology 1993; 187 (3) 821-825
  • 7 Kaplan PA, Walker CW, Kilcoyne RF, Brown DE, Tusek D, Dussault RG. Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging. Radiology 1992; 183 (3) 835-838
  • 8 Luo CF, Sun H, Zhang B, Zeng BF. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 2010; 24 (11) 683-692
  • 9 Stoller DW, Martin C, Crues III JV, Kaplan L, Mink JH. Meniscal tears: pathologic correlation with MR imaging. Radiology 1987; 163 (3) 731-735
  • 10 Sohn HS, Yoon YC, Cho JW, Cho WT, Oh CW, Oh JK. Incidence and fracture morphology of posterolateral fragments in lateral and bicondylar tibial plateau fractures. J Orthop Trauma 2015; 29 (2) 91-97
  • 11 Carlson DA. Posterior bicondylar tibial plateau fractures. J Orthop Trauma 2005; 19 (2) 73-78
  • 12 He X, Ye P, Hu Y , et al. A posterior inverted L-shaped approach for the treatment of posterior bicondylar tibial plateau fractures. Arch Orthop Trauma Surg 2013; 133 (1) 23-28
  • 13 Barei DP, Nork SE, Mills WJ, Coles CP, Henley MB, Benirschke SK. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am 2006; 88 (8) 1713-1721
  • 14 Abdel-Hamid MZ, Chang CH, Chan YS , et al. Arthroscopic evaluation of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases. Arthroscopy 2006; 22 (6) 669-675