Abstract

Introduction: Tibial plateau fractures are one of the common fractures that occur near the knee. These fractures are mainly due to high-velocity injuries. So, there is a high risk of ligamentous and meniscal injuries. It is always important to identify associated ligamentous and/or meniscus injuries in tibial plateau fracture that can change the treatment plan. This study aims to assess the association of ligamentous and/or meniscal injuries in patients with tibial plateau fractures. Materials and methods: This prospective observational study was conducted in the Department of Orthopaedics in B&B Hospital from September 2021 to May, 2022. 40 patients who meet the inclusion criteria were included in the study. All tibial plateau fractures were classified according to the Schatzker classification. MRI was reported by a single radiologist with a fellowship in musculoskeletal radiology. MRI findings were recorded and an association was studied with different types of tibial plateau fractures. Results: Out of 40 patients, 36(90%) patients had ligamentous and/or meniscal injuries. The mean age of the patients was 38.9 years. The majority of the cases were due to road traffic accidents. 40% of the cases had ligamentous injuries only, 15% had meniscal injuries only and 35% had both ligamentous and meniscal injuries. Among ligamentous injuries (isolated or combined), ACL injury was common (77%). Among meniscus injuries (isolated or combined), lateral meniscus injury was common (70%). Schatzker type II fracture had a high association with ligamentous and/or meniscal injuries.

• 1.   Burri C., Bartzke G., Coldewey J, Muggler E. Fractures of the tibial plateau. Clin Orthop Relat Res. 1979; NO. 138: 84–93. PMID: 445922.
• 2.   Blokker C.P., Rorabeck C.H., Bourne R.B. Tibial plateau fractures. An analysis of the results of treatment in 60 patients. Clin Orthop Relat Res. 1984; 182: 193–9. PMID: 6546361.
• 3.   Bennett W.F., Browner B. Tibial plateau fractures: A study of associated soft tissue injuries. J Orthop Trauma. 1994;8(3):183–8. PMID: 8027885.
• 4.   Stannard J.P., Lopez R., Volgas D. Soft tissue injury of the knee after tibial plateau fractures. J Knee Surg. 2010 Dec; 23(4): 187–92. PMID: 21446623.
• 5.   Barrow B.A., Fajman W.A., Parker L.M., Albert M.J., Drvaric D.M., Hudson T.M. Tibial plateau fractures: Evaluation with MR imaging. Radiographics. 1994; 14(3): 553–9. doi: 10.1148/ radiographics.14.3.8066271.
• 6.   Brophy D.P., O’Malley M., Lui D., Denison B., Eustace S. MR imaging of tibial plateau fractures. Brain Lang. 1996; 51(12): 873–8. doi: 10.1016/s0009-9260(96)80086-9.
• 7.   Holt M.D., Williams L.A., Dent C.M. MRI in the management of tibial plateau fractures. Injury. 1995; 26(9): 595–9.
• 8.   Ali A.M., Burton M., Hashmi M., Saleh M. Treatment of displaced bicondylar tibial plateau fractures (OTA-41C2&3) in patients older than 60 years of age. J Orthop Trauma. 2003 May; 17(5): 346–52. doi: 10.1016/0020- 1383(95)00109-m.
• 9.   Kode L., Lieberman J.M., Motta A.O., Wilber J.H., Vasen A., Yagan R. Evaluation of tibial55 JOE/Volume 11 Number 2, May-August 2025 plateau fractures: Efficacy of MR imaging compared with CT. Am J Roentgenol. 1994; 163(1): 141–7. doi: 10.2214/ajr.163.1.8010201.
• 10.   Gaudinez R.F., Mallik A.R., Szporn M. Hybrid external fixation of comminuted tibial plateau fractures. Clin Orthop Relat Res. 1996; 328:203– 10. doi: 10.1097/00003086-199607000-00032.
• 11.   Outcome of complex fractures of the tibial plateau treated with a beam-loading ring fixation system. J Bone Joint Surg Br. 2003 Jul; 85(5): 691-9. PMID: 12892192
• 12.   Stannard J.P., Wilson T.C., Volgas D.A., Alonso J.E. The less invasive stabilization system in the treatment of complex fractures of the tibial plateau: short-term results. J Orthop Trauma. 2004 Sep; 18(8): 552–8. doi: 10.1097/00005131- 200409000-00012.
• 13.   Colletti P., Greenberg H., Terk M.R. M.R. findings in patients with acute tibial plateau fractures. Comput Med Imaging Graph. 1996 Sep; 20(5): 389–94. doi: 10.1016/s0895- 6111(96)00054-7.
• 14.   Shepherd L., Abdollahi K., Lee J., Vangsness C.T. The prevalence of soft tissue injuries in nonoperative tibial plateau fractures as determined by magnetic resonance imaging. J Orthop Trauma. 2002 Oct; 16(9): 628–31. doi: 10.1097/00005131-200210000-00003.
• 15.   Yacoubian S.V., Nevins R.T., Sallis J.G., Potter H.G, Lorich D.G. Impact of MRI on treatment plan and fracture classification of tibial plateau fractures. J Orthop Trauma. 2002 Oct; 16(9): 632–7. doi: 10.1097/00005131-200210000-00004