The Incidence of Posterolateral Tibial Plateau Fractures in the Setting of Knee Dislocations.
| Title: | The Incidence of Posterolateral Tibial Plateau Fractures in the Setting of Knee Dislocations. |
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| Authors: | Korthaus A; Department of Trauma Surgery and Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Marx P; Department of Trauma Surgery and Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Braun PJ; Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany.; Colcuc S; Department of Arthroscopic Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.; Behrendt P; Department of Orthopedic and Trauma Surgery, Asklepios Klinik St Georg, Hamburg, Germany.; Hoffmann M; Department of Orthopedic and Trauma Surgery, Asklepios Klinik St Georg, Hamburg, Germany.; Drenck T; Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Germany. C.S. and M.K. are co-last authors.; Akoto R; Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Germany. C.S. and M.K. are co-last authors.; Frosch KH; Department of Trauma Surgery and Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.; Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Germany. C.S. and M.K. are co-last authors.; Schoepp C; Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany.; Krause M; Department of Trauma Surgery and Orthopedics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. |
| Source: | Orthopaedic journal of sports medicine [Orthop J Sports Med] 2025 May 29; Vol. 13 (5), pp. 23259671251338795. Date of Electronic Publication: 2025 May 29 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]- |
| Abstract: | Background: Acute knee dislocations are devastating injuries that can be challenging for surgeons to treat. The bony integrity of the tibial plateau and the lateral femoral condyle has a fundamental meaning for translational and rotational knee joint stability. Posterolateral tibial plateau depression fractures (PLTPFs) and lateral femoral condyle impaction fractures (LFCIFs) can influence clinical outcomes, but their frequency and characteristics in the setting of acute knee dislocations are unknown.; Purpose: To report the incidence of PLTPFs and LFCIFs in acute knee dislocations as well as to describe concomitant soft tissue lesions associated with these bony injuries.; Study Design: Cross-sectional study; Level of evidence, 3.; Methods: In this retrospective multicenter study, acute knee dislocations (at least bicruciate ligament injuries) were identified from hospital information systems based on diagnosis-related group coding as well as operation and procedure classification coding at 5 participating level 1 trauma centers from 2018 to 2022. The knee dislocations were categorized according to the Schenck classification. Soft tissue injuries were assessed on magnetic resonance imaging within 2 weeks of the trauma. PLTPFs and LFCIFs were categorized on magnetic resonance imaging and computed tomography according to the Menzdorf and Bernholt classifications.; Results: A total of 157 knee dislocations were identified, comprising 106 men and 51 women with a mean age of 39.3 ± 15.1 years. A PLTPF was detected in 42 (26.8%) knee dislocations, with the highest frequency in Schenck type III medial dislocations. Of these 42 cases, 26 (61.9%) PLTPFs were rated as high-grade fractures, theoretically requiring reduction and fixation. An LFCIF was found in 31 (19.7%) of the cases.; Conclusion: A PLTPF was observed in one-quarter, and an LFCIF in one-fifth, of acute knee dislocations. They occurred particularly in knee dislocations with medial collateral ligament ruptures. Almost two-thirds of all PLTPFs presented as high-grade fractures according to the Menzdorf or Bernholt classification, potentially requiring a surgical intervention.; (© The Author(s) 2025.) |
| Competing Interests: | The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from the Hamburg Ethics Committee (2021-300079-WF). |
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| Contributed Indexing: | Keywords: apple-bite fracture; knee dislocation; lateral femoral notch sign; multiligament injury; posterolateral tibial plateau depression fracture |
| Entry Date(s): | Date Created: 20250602 Latest Revision: 20250603 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12123113 |
| DOI: | 10.1177/23259671251338795 |
| PMID: | 40453960 |
| Database: | MEDLINE |
Journal Article