Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 4 Issue 6

Plateau Tibial Fractures are Associated with High Rates of Major Ligaments Ruptures

Manuel Mosquera1*, Juan Ricardo Gil2, Juan Manuel Mosquera3, David Portilla3, Andrés Felipe Vence3 and Yessica Paola González F4

1Orthopedist, Clínica Erasmo, Valledupar, Clínica La Carolina, Bogota, Colombia
2Orthopedist, Clínica Erasmo, Valledupar, Colombia
3General Practitioner, Clínica Erasmo, Valledupar, Colombia
4Physiotherapist, Research Coordinator, Clínica Erasmo, Valledupar, Colombia

*Corresponding Author: Manuel Mosquera, Orthopedist, Clínica Erasmo, Valledupar, Clínica La Carolina, Bogota, Colombia.

Received: April 22, 2021; Published: May 17, 2021

Abstract

Summary: Tibial Plateau fractures are injuries that usually result from high energy trauma, especially those involving motorcycle accidents. The association of meniscal and ligament injuries in this type of fracture is described in the literature, especially grade IV, V and VI, according to the Schatzker classification.

Purpose: To know the frequency of injuries of the major ligaments in patients with tibial plateau fracture according to the Schatzker classification and to present a sub-group of patients intervened due to anterior and/or posterior instability, describing the type of lesion, its location, the treatment used and the short-term follow-up.

Materials and Methods: We reviewed the medical records of the patients who were diagnosed with tibial plateau fracture from January 2014 to January 2018, analyzing the type of fracture according to Schatzker and those who presented secondary ligament instability diagnosed after the consolidation of the fracture.

Results: A total of 302 patients with tibial plateau fractures were presented, of which 63 (20.8%) had involvement of one or more of the major ligaments. The lesions occurred in all types of fracture primarily in type II, V and VI. The most frequent ligament torn was the Anterior Cruciate Ligament (ACL) in 52 patients (17.2%), with the type II fracture causing the most injury. Of the 63 patients with instability, for administrative reasons only 13 patients (20%) were operated, 11 of whom had ACL injury. 91% of the ligament injuries found at the time of surgery preserved a large part of their remnant’s fibers with elongation.

Conclusion: Tibial plateau fractures have a high association of lesions in the major ligaments, presenting in this study in one per five patients.

Keywords: Plateau Tibial Fractures

References

  1. Schatzker J., et al. “The tibial plateau fracture: the Toronto experience: 1968–1975”. Clinical Orthopaedics and Related Research 138 (1979): 94-104.
  2. Luo CF., et al. “Three-column fixation for complex tibial plateau fractures”. Journal of Orthopaedic Trauma 24 (2010): 683-692.
  3. Tang HC., et al. “Correlation of parameters on preoperative CT images with intra-articular soft-tissue injuries in acute tibial plateau fractures: A review of 132 patients receiving ARIF”. Injury3 (2017): 745-750.
  4. Porrino J., et al. “Association of Tibial Plateau Fracture Morphology With Ligament Disruption in the Context of Multiligament Knee Injury”. Current Problems in Diagnostic Radiology 6 (2018): 410-416.
  5. Spiro AS., et al. “The degree of articular depression as a predictor of soft-tissue injuries in tibial Plateau fracture”. Knee Surgery, Sports Traumatology, Arthroscopy 3 (2013): 564-570.
  6. Gardner MJ., et al. “The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients”. Orthopaedic Trauma 2 (2005): 79-84.
  7. Abdel-Hamid MZ., et al. “Artroscópica evaluación of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases”. Arthroscopy6 (2006): 669-675.
  8. Ebrahimzadeh MH., et al. “Clinical instability of the knee and functional differences following tibial plateau fractures versus distal femoral fractures”. Trauma Monthly 1 (2015).
  9. Ferran Abat., et al. “Promising short-term results following selective bundle reconstruction in partial anterior cruciate ligament tears 20.5 (2013): 332-338.
  10. Adeeb M and Moran CG. “Fractures around the Knee”. Surg9 (2003): 228-230.
  11. Delamarter RB., et al. “Ligament injuries associated with tibial plateau fractures”. Clinical Orthopaedics and Related Research 250 (1990): 226-233.
  12. Shepherd L., et al. “The prevalence of soft tissue injuries in nonoperative tibial plateau fractures as determined by magnetic resonance imaging”. Journal of Orthopaedic Trauma 9 (2002): 628-631.
  13. Abdel-Hamid MZ., et al. “Artroscópica evaluación of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases”. Arthroscopy 6 (2006): 669-675.
  14. Delamarter RBv. “Ligament injuries associated with tibial plateau fractures”. Clinical Orthopaedics and Related Research 250 (1990): 226-233.
  15. Bennett WF and Browner B. “Tibial plateau fractures: a study of associated soft tissue injuries”. Journal of Orthopaedic Trauma 3 (1994): 183-188.
  16. Abdel-Hamid MZ., et al. “Arthroscopic evaluation of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases”. Arthroscopy6 (2006): 669-675.
  17. Colletti P., et al. “MR findings in patients with acute tibial plateau fractures”. Computerized Medical Imaging and Graphics 5 (1966): 389-394.
  18. Gardner MJ., et al. “The incidence of soft tissue injury in operative tibial plateau fractures: a magnetic resonance imaging analysis of 103 patients”. Journal of Orthopaedic Trauma 2 (2005): 79-84.
  19. Vanh Der List J., et al. “Arthroscopic primary repair of proximal anterior cruciate ligament tears seems safe but higher level of evidence is needed: a systematic review and meta-analysis of recent literature”. Knee Surgery, Sports Traumatology, Arthroscopy 6 (2020): 1946-1957.
  20. Jiang L., et al. “Two Cases of Contact Anterior Cruciate Ligament Rupture Combined with a Posterolateral Tibial Plateau Fracture”. Case Reports in Orthopedics (2015): 250487.

Citation

Citation: Manuel Mosquera., et al. “Plateau Tibial Fractures are Associated with High Rates of Major Ligaments Ruptures".Acta Scientific Orthopaedics 4.6 (2021): 32-36.

Copyright

Copyright: © 2021 Manuel Mosquera., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US