An unclassified tibial plateau fracture: Reverse Schatzker type IV
The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a cas...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-08-01
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| Series: | Chinese Journal of Traumatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127517303139 |
| _version_ | 1818153331182272512 |
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| author | Tien Yeoh Efthymios Iliopoulos Alex Trompeter |
| author_facet | Tien Yeoh Efthymios Iliopoulos Alex Trompeter |
| author_sort | Tien Yeoh |
| collection | DOAJ |
| description | The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level 1 major trauma centre emergency department. His injuries were a circumferential degloving injury to his left leg and a right lateral tibial plateau fracture/knee dislocation. The pattern of the lateral tibial plateau fracture was unique and did not fit any recognised classification system. The patient received a spanning external fixator initially and after latency of 12 days for soft tissue resuscitation he underwent definite fixation through an antero-lateral approach to the proximal tibia with two cannulated 6.5 mm partially threaded screws and an additional lateral proximal tibia plate in buttress mode. A hinged knee brace was applied with unrestricted range of motion post-operatively and free weight bearing were permitted post operatively. At the 6 months follow up, the patient walks without aids and with no limp. Examination revealed a stable joint and full range of motion. Plain radiographs revealed that the fracture healed with good alignment and the fixation remained stable. High energy injuries can lead to more complicated fracture patterns, which challenge the orthopaedic surgeons in their management. It is crucial to understand the individual fracture pattern and the possible challenges that may occur. This study reports a lateral tibia plateau fracture/dislocation which perhaps is best described as a reverse Schatzker IV type fracture. Keywords: Knee, Tibial plateau fractures, Schatzker classification, Lower limb trauma |
| first_indexed | 2024-12-11T14:08:55Z |
| format | Article |
| id | doaj.art-72f64e47b518470d919856097a25b5fa |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-12-11T14:08:55Z |
| publishDate | 2018-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-72f64e47b518470d919856097a25b5fa2022-12-22T01:03:31ZengElsevierChinese Journal of Traumatology1008-12752018-08-01214211215An unclassified tibial plateau fracture: Reverse Schatzker type IVTien Yeoh0Efthymios Iliopoulos1Alex Trompeter2St George's University Hospital, NHS Trust, London, United KingdomCorresponding author.; St George's University Hospital, NHS Trust, London, United KingdomSt George's University Hospital, NHS Trust, London, United KingdomThe most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level 1 major trauma centre emergency department. His injuries were a circumferential degloving injury to his left leg and a right lateral tibial plateau fracture/knee dislocation. The pattern of the lateral tibial plateau fracture was unique and did not fit any recognised classification system. The patient received a spanning external fixator initially and after latency of 12 days for soft tissue resuscitation he underwent definite fixation through an antero-lateral approach to the proximal tibia with two cannulated 6.5 mm partially threaded screws and an additional lateral proximal tibia plate in buttress mode. A hinged knee brace was applied with unrestricted range of motion post-operatively and free weight bearing were permitted post operatively. At the 6 months follow up, the patient walks without aids and with no limp. Examination revealed a stable joint and full range of motion. Plain radiographs revealed that the fracture healed with good alignment and the fixation remained stable. High energy injuries can lead to more complicated fracture patterns, which challenge the orthopaedic surgeons in their management. It is crucial to understand the individual fracture pattern and the possible challenges that may occur. This study reports a lateral tibia plateau fracture/dislocation which perhaps is best described as a reverse Schatzker IV type fracture. Keywords: Knee, Tibial plateau fractures, Schatzker classification, Lower limb traumahttp://www.sciencedirect.com/science/article/pii/S1008127517303139 |
| spellingShingle | Tien Yeoh Efthymios Iliopoulos Alex Trompeter An unclassified tibial plateau fracture: Reverse Schatzker type IV Chinese Journal of Traumatology |
| title | An unclassified tibial plateau fracture: Reverse Schatzker type IV |
| title_full | An unclassified tibial plateau fracture: Reverse Schatzker type IV |
| title_fullStr | An unclassified tibial plateau fracture: Reverse Schatzker type IV |
| title_full_unstemmed | An unclassified tibial plateau fracture: Reverse Schatzker type IV |
| title_short | An unclassified tibial plateau fracture: Reverse Schatzker type IV |
| title_sort | unclassified tibial plateau fracture reverse schatzker type iv |
| url | http://www.sciencedirect.com/science/article/pii/S1008127517303139 |
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