Journal of Musculoskeletal Trauma

Prediction of Concomitant Lateral Meniscus Injury with a Tibia Plateau Fracture Based on Computed Tomography Assessment: Wonchul Choi, Yunseong Choi, Go Tak Kim; J Korean Fract Soc 2018;31(4):132-138. Published online October 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.4.132

PURPOSE
This study examined whether any fracture pattern shown in computed tomography (CT) scan is associated with the presence of lateral meniscus (LM) injury in a tibia plateau fracture.
MATERIALS AND METHODS
Fifty-three tibia plateau fractures with both preoperative CT and magnetic resonance imagings (MRI) available were reviewed. The patient demographics, including age, sex, body mass index, and energy level of injury were recorded. The fracture type according to the Schatzker classification, patterns including the lateral plateau depression (LPD), lateral plateau widening (LPW), fracture fragment location, and the number of columns involved were assessed from the CT scans. The presence of a LM injury was determined from the MRI. The differences in the factors between the patients with (Group 1) and without (Group 2) LM injuries were compared and the correlation between the factors and the presence of LM injury was analyzed.
RESULTS
The LM was injured in 23 cases (Group 1, 43.4%) and intact in 30 cases (Group 2, 56.6%). The LPD in Group 1 (average, 8.2 mm; range, 3.0â€“20.0 mm) and Group 2 (average, 3.8 mm; range, 1.4â€“12.1 mm) was significantly different (p < 0.001). The difference in LPW of Group 1 (average, 6.9 mm; range, 1.2â€“15.3 mm) and Group 2 (average, 4.8 mm; range, 1.4â€“9.4 mm) was not significant (p=0.097). The other fracture patterns or demographics were similar between in the two groups. Regression analysis revealed that an increased LPD (p=0.003, odds ratio [OR]=2.12) and LPW (p=0.048, OR=1.23) were significantly related to the presence of a LM tear.
CONCLUSION
LPD and LPW measured from the CT scans were associated with an increased risk of concomitant LM injury in tibia plateau fractures. If such fracture patterns exist, concomitant LM injury should be considered and an MRI may be beneficial for an accurate diagnosis and effective treatment.

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The value of magnetic resonance imaging in the preoperative diagnosis of tibial plateau fractures: a systematic literature review
Gregoire Thürig, Alexander Korthaus, Karl-Heinz Frosch, Matthias Krause
European Journal of Trauma and Emergency Surgery.2023; 49(2): 661. CrossRef

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Prevalence of Meniscus Tear in Tibial Plateau Fractures: Jung Man Kim, Dong Yup Lee, Young Joon Yang; J Korean Fract Soc 2006;19(3):319-321. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.319

Abstract: PURPOSE
To evaluate the pattern of meniscal tear according to the type of the tibial plateau fracture of Schatzker.
MATERIALS AND METHODS
Sixty two cases of tibial condyle fracture treated between the period of 1994 and 2003 were evaluated. The fracture type was classified according to Schatzker. The pattern and extent of the meniscus tear were compared with the fracture classification. Statistical analysis was made with the Fisher's exact test.
RESULTS
Meniscus tear was noted in 29 cases out of 62 fractures (46.8%). The twenty cases of minimally displaced fractures treated conservatively showed no meniscal tear. Of 18 cases of the most common type I fracture 2 (11.2%) had a meniscus tear. Of 16 type II fractures 12 (75%) had a meniscus tear. The type III fracture showed the highest prevalence of meniscus tear (76.9%, 10/13). There was statistically significant relationtionship between the type of fractures and the rate of meniscus tear (p<0.0001).
CONCLUSION
The meniscus tear frequently occurred in tibial plateau fractures in Schatzker type II and III. Associated meniscus tears should be born in mind when those types of fracture are encountered.

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Meniscal Injuries with Tibial Plateau Fractures: Yong In, Won Jong Bahk, Oh Soo Kwon, Chae Gwan Kong, Ju Young Kim; J Korean Soc Fract 2003;16(4):490-495. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.490

Abstract PDF: PURPOSE
The purpose of this study is to evaluate by arthroscopy the incidence of meniscal injury and the result of its treatment in fractures of the tibial plateau.
MATERIALS AND METHODS
From March 2000 to July 2002, twenty-three patients with tibial plateau fractures were examined and treated by arthroscopy before reduction of the fractures. Following the classification by Schatzker, there were 3 pure cleavage fractures (type I), 7 with cleavage and depression (type II), 4 with pure central depression (type III), one medial condyle fracture (type IV) and 8 with meta-diaphyseal fractures (type VI). Meniscal injuries were treated by meniscectomy or meniscal repair. Second look arthroscopy for patients treated with meniscal repair were performed at 6 months after operation or at time of the fixative removal.
RESULTS
Thirteen knees (56%) were found to have meniscal injuries. There were 11 lateral meniscal tears, eight of which were periphral and repaired. There were 3 complex lateral meniscal tears which required partial meniscectomy. The five medial meniscal tears were required all partial meniscectomy. Six of the eight patients who were repaired the meniscal tears evaluated by second look arthroscopy. Five patient showed complete healing and one showed incomplete healing.
CONCLUSION
Every effort should be made to repair the meniscal tears in tibial plateau fractures.

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Injury of Lateral Meniscus Associated with Tibia Plateau Fracture: Young Bok Jung, Suk Kee Tae, Dong Lyul Yang, Jae Sung Lee, Jung Il Lim; J Korean Soc Fract 2001;14(1):60-65. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.60

Abstract PDF: PURPOSE
To analyse the frequency of soft tissue injuries associated with tibial plateau fracture through arthoscopy and demonstrate the pattern and treatment of lateral meniscal tear which is the most frequently concomitant injury. MATERIAL AND METHOD: We evaluated the charts, X-rays and arthoscopic records of the 27 patients who had been diagnosed as tibial plateau fracture and received the arthoscopic examination or arthoscopic assisted operative management and analysed the injury pattern, association of schatzker classification and treatment of the 9 patients who had been concomitant with lateral meniscal tear.
RESULT
In our cases, lateral meniscus tear was the most common among the soft tissue injury it was revealed that a longitudinal tear at the peripheral area was shown in 8 cases, which were treated with meniscal repair and a radial tear of the central area in l cases, treated with partial menisectomy.
CONCLUSION
Lateral meniscus injury is one of the most frequently concomitant with tibial plateau fracture, In those cases, arthroscopic meniscal repair would be helpful for better prognosis.

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Avulsion Fracture of The Medial Meniscus: A Case Report: Hyoung Soo Kim, Seung Rim Park, Joon Soon Kang, Woo Hyeong Lee, Kil Seok Ko; J Korean Soc Fract 2000;13(1):109-112. Published online January 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.1.109

Abstract PDF: Post-traumatic meniscal ossicle due to avulsion fracture of medial meniscus was very rare. They were often associated with meniscal tear, but caused symptoms without a tear, by mass effect from protruding meniscal contour. so it had to be differential diagnosised with free loose body in the knee joint. We experienced a symptomatic meniscal ossicle due to post-traumatic avulsion fracture of the posterior horn of medial meniscus, and managed with open reduction, internal fixation with screw and washer after arthroscopic examination. We report a rare case of meniscal ossicle in detail with literature

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Risk Group of Lateral Meniscus Injury in Fracture of Lateral Tibial Condyle: Jung Man Kim, Cheong Ho Chang, Doo Hoon Sun, Jeong Tae Seo, Seok Joong Kim; J Korean Soc Fract 1999;12(3):601-606. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.601

Abstract PDF: PURPOSE
Untreated meniscus injuries accompanied with fractures of lateral tibial condyle may cause prolonged pain and post-traumatic arthritis. Lateral displacement of fractured fragment of lateral tibial condyle was found to be related to the incidence of lateral meniscus tear. We established the risk groups for lateral meniscus injuries on the basis of the degree of the lateral displacement of lateral tibial condyle.
MATERIALS and METHODS
Risk groups for lateral meniscus injury in fractures of lateral tibial condyle were evaluated in 39 knees, retrospectively, using plain roentgenograms and arthroscopic findings. On the knee anteroposterior radiography, displacement of lateral tibia condyle were classified into three groups according to the probability of lateral meniscus INJURY: high risk group for above 8mm of lateral displacement; moderate risk group for 4-8mm; low risk group for less than 4mm.
RESULTS
High risk group has ten meniscus injuries among 13 knees(76.9%) and moderate risk group had the seven meniscus injuries of 18 knees(38.9%). Low risk group of eight knees had no meniscus injury(0%). These different incidences among groups were statistically significant(p<0.05).
CONCLUSIONS
The authors suggest that the incidence of lateral meniscus injury was related to the degree of lateral displacement of lateral tibial condyle, and our definition of risk groups are useful for prediction of lateral meniscus injury in fracture of lateral tibial condyle.

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Injuries of the Knee Associated with Fractures of the Tibial Shaft: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):277-283. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.277

Abstract PDF: Two hundred and seventeen consecutive patients with two hundred and twenty five diaphyseal tibia fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from May 1993 to Feb 1997 at Eulji Medical College Hospital. Average follow-up period was 41 months(20~65 months). Thirteen patients with knee injuries(5.8%) were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Eleven patients(84.6%) were diagnosed as having a ligament or meniscus injury at the time of initial management. The posterior cruciate ligament(PCL) was injured in eight patients(50%); the anterior cruciate ligament(ACL), in three; the medial collateral ligament, in three; the lateral collateral ligament, in two: the medial meniscus, in two; and the lateral meniscus, in two. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Collateral ligament injuries, two ACL, and four PCL injuries were treated conservatively and one PCL injuries were treated with pull-out suture technique and another four PCL injuries were treated with reconstruction using bone-patella tendon-bone. One ACL injury was treated with reconstruction using semitendinosus tendon. As evaluated by the method of HSS knee score, there were seven(53.9%) excellent, four(30.8%) good, and two fair(15.3%). On the basis of the results of this study, we believe that, after stabilization of a fracture of the tibial shaft, it is essential to examine the knee throughly to identify any associated ligamentous injuries.

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