Tibial plateau fracture classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo’s three column concept and AO classification.

Classification

There are multiple classifications available for tibial plateau fracture. The most common classification systems for tibial plateau fracture include Schatzker, Hohl and Moore, Luo’s three column concept and AO/OTA classification.^[1]^[2]

Schatzker Classification

Schatzker classification is the most commonly used classification for tibial plateau fracture.^[3]

Schatzker Classification
Type I	Lateral split fracture
Type II	Lateral Split-depressed fracture
Type III	Lateral Pure depression fracture
Type IV	Medial plateau fracture
Type V	Bicondylar fracture
Type VI	Metaphyseal-diaphyseal dissociation

Hohl and Moore Classification

Hohl and Moore classification of tibial plateau fracture is useful for fracture dislocation, fracture patterns that cannot be classified by Schatzker classification and fractures associated with knee instability.^[4]

Hohl and Moore Classification
Type I	Coronal split fracture
Type II	Entire condylar fracture
Type III	Rim avulsion fracture of lateral plateau
Type IV	Rim compression fracture
Type V	Four-part fracture

Luo’s Three Column Classification

Luo’s classified tibial plateau fracture based on computed tomography ‘‘three column fixation’’ concept which aided in column-specific fixation technique.^[5]

Luo’s Three Column Classification
Zero-column fracture	Pure articular depression
1 Column fracture	Lateral column fracture
2 Column fracture	Lateral and posterior column fracture
3 Column fracture	Bicondylar fracture dividing into three fragments

OTA System

AO/ASIF classification is also a widely accepted classification.^[6]
Proximal tibia is given the number 41 based on the classification.
It is further subdivided as:

OTA System
A	Extra-articular fractures
	A1	Avulsion
	A2	Metaphyseal simple
	A3	Metaphyseal multifragmentary
B	Partial articular fractures
	B1	Pure split
	B2	Pure depression
	B3	Split depression
C	Complete articular fractures
	C1	Articular simple + metaphyseal simple
	C2	Articular simple, metaphyseal multifragmentary
	C3	Articular multifragmentary

References

↑ Rockwood, Charles (2010). Rockwood and Green’s fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
↑ Azar, Frederick (2017). Campbell’s operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
↑ Schatzker J, McBroom R, Bruce D (1979). “The tibial plateau fracture. The Toronto experience 1968–1975”. Clin Orthop Relat Res (138): 94–104. PMID 445923.
↑ Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts CM, editor. Surgery of the musculoskeletal system. 2nd ed., New York: Churchill Livingstone; 1990.
↑ Luo CF, Sun H, Zhang B, Zeng BF (2010). “Three-column fixation for complex tibial plateau fractures”. J Orthop Trauma. 24 (11): 683–92. doi:10.1097/BOT.0b013e3181d436f3. PMID 20881634.
↑ ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.

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[1] Rockwood, Charles (2010). Rockwood and Green’s fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.

[2] Azar, Frederick (2017). Campbell’s operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.

[pmid445923-3] Schatzker J, McBroom R, Bruce D (1979). “The tibial plateau fracture. The Toronto experience 1968–1975”. Clin Orthop Relat Res (138): 94–104. PMID 445923.

[4] Hohl M, Moore TM. Articular fractures of the proximal tibia. In: Evarts CM, editor. Surgery of the musculoskeletal system. 2nd ed., New York: Churchill Livingstone; 1990.

[pmid20881634-5] Luo CF, Sun H, Zhang B, Zeng BF (2010). “Three-column fixation for complex tibial plateau fractures”. J Orthop Trauma. 24 (11): 683–92. doi:10.1097/BOT.0b013e3181d436f3. PMID 20881634.

[6] ME Muller, S Nazarian, P Koch. Classification AO des fractures. 1 Les os longs. Springler-Verlag, Berlin, 1987.

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