Emergency #35

61-year-old female:
– Trauma
– Fracture? What do you see?

Showing the supine AP and lateral view, due to the inability to stand on the right leg.

Click here to see the answer

Diagnosis: Lipohemarthrosis (fat-blood level) indicating intra-articular #
Comminutive though non-displaced tibia plateau fracture Avulsion fracture proximal fibula (Segond fracture – 100% association with ACL injury)
CT: Schatzker type VI

Schatzker tibia plateau classification

Schatzker I: wedge-shaped pure cleavage fracture of the lateral tibial plateau, having less than 4 mm of depression or displacement
Schatzker II: splitting and depression of the lateral tibial plateau; namely, type I fracture with a depressed component
Schatzker III: pure depression of the lateral tibial plateau; divided into two subtypes:
Schatzker IIIa: with lateral depression
Schatzker IIIb: with central depression
Schatzker IV:  medial tibial plateau fracture with a split or depressed component
Schatzker V: wedge fracture of both lateral and medial tibial plateau
Schatzker VI: transverse tibial metadiaphyseal fracture, along with any type of tibial plateau fracture (metaphyseal-diaphyseal discontinuity)

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