A 44-year-old woman is met with motor accident and suffers right sided tibial plateau fracture. She is neurovascularly intact, and her compaments are soft. She has no other significant injuries, except for a minor concussion and several broken ribs. Which of the following, if present, is an indication for operative fixation
Indications for operative fixation for tibial plateau fractures include high- energy plateau injuries (Schatzker IV through VI) or any plateau fracture with aicular step-off greater than 3 mm, condylar widening greater than 5 mm, or instability with varus or valgus stresses. Concomitant ACL, meniscal, or even ankle fractures are not necessarily indications for fixation if the reduction is adequate and the fracture is immobilized. Classification:- The Schatzker classification is commonly used to describe tibial plateau fractures. They are classified in the following way: Type I Lateral split Type II Lateral split depression Type III Lateral pure depression Type IV Medial plateau split and/or depression Type V Bicondylar Type VI Metaphyseal-diaphyseal disassociation Schatzker I through III fractures are generally considered low-energy injuries, whereas IV through VI injuries are high-energy injuries.<img alt="" src=" />
Aicular step-off 5 mm
ACL tear on follow-up MRI
Condylar widening < 3 mm
Lateral meniscal tear on follow-up MRI
Thigh, Knee,Leg,Foot & Ankle injuries