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T he tibia the most common

fractured long bone in the body

Fractures of the T ibial Plateu

Account for 1% of all fractures

Isolated lateral are the most common

Classified according to Schatzker

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S chatzker I Lateral split :

Split fracture of the lateral tibialplateau without depression.Etiology: Often due to valgus

stress. Occurs in younger patients with stronger bones,which are resistant todepression. Often due to abumper injury.Common associated injuries:Lateral meniscal tear. T he lateralmeniscus may also becomeentrapped in the fracture andrequire arthroscopy.T reatment: T ypically, lateral

fixation.

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S chatzker II S plit with

depressionM ost common tibial plateau fracture.Definition: Split depression of the lateral tibialplateau.

Etiology: Often due to valgus or axial stress.Occurs in older patients with osteoporosiswith bones that do not resist depression.Common associated injuries: Lateral

meniscus, medial meniscus, and medialcollateral ligament.T reatment: T ypically, lateral fixation. T hedepressed fragments are elevated andsupported with bone graft.

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S chatzker III Pure lateral

depressionDefinition: Lateral depressionEtiology: Older patients withosteoporosis. Often just due to afall.Common associated injuries: If thedepressed fragments are lateraland posterior, it is associated with

joint instability.

T reatment: If there is instability, thefractured fragments are elevatedand supported with bone graft andlateral internal fixation.

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S chatzker IV Pure medial

depressionDefinition: M edial tibial plateau fracture thatmay be a split or split depression typefracture. M ay also involve the tibial spines.Etiology: Varus stress. Often severe

trauma.Common associated injuries: Associatedwith avulsion of the intercondylar eminence,which may indicate anterior cruciateligament injury. Lateral collateral ligament

injury. Peroneal nerve injury. Poplitealartery injury.T reatment: M edial plate and screws.

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S chatzker V Bicondylar

Definition: Split medial and lateraltibial plateau (Bicondylar).M etaphysis is still in continuity withthe diaphysis.Etiology: Often pure axial stress withsevere trauma.Common associated injuries:Neurovascular, ACL, and meniscalinjuries.T reatment: T ypically, medial andlateral internal fixation.

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S chatzker VI S plit extends to

metadiaphysisDefinition: M etaphyseal fracture thatseparates the articular surface fromthe diaphysis. M ay involve themedial, lateral, or both articular

surfaces.Etiology: High-energy trauma.Common associated injuries:

Neurovascular injury andcompartment syndrome. Alsomeniscal, ACL, and collateralligament injuries.T reatment: T ypically medial andlateral internal fixation.

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