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 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.
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.
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.
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 the widely accepted classification.
  • 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

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