Tibial Plateau Fracture Characteristics: Computed

Tomography Mapping of Lateral, Medial, and Bicondylar

Fractures
by Rik J. Molenaars, Jos J. Mellema, Job N. Doornberg, and Peter Kloen

J Bone Joint Surg Am

Volume 97(18):1512-1520
September 16, 2015

2015 by The Journal of Bone and Joint Surgery, Inc.

Fracture mapping of tibial plateau fractures is performed by (1) selecting the most proximal
subarticular axial CT image as a reference; (2) dynamically scrolling through the axial, sagittal,
and coronal CT images to define the origin and subsequent (virtua...

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

Application of the fracture-mapping technique to a Schatzker type-IV fracture (Fig. 2-A), a

Schatzker type-V fracture (Fig. 2-B), and a Schatzker type-VI fracture (Fig. 2-C).

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

A complete fracture map of the 127 tibial plateau fractures in the series.

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

Fracture maps of the sixty-four lateral fractures (Fig. 4-A), fifteen medial fractures (Fig. 4-B), and
forty-eight bicondylar fractures (Fig. 4-C).

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

The main features of tibial plateau fractures are a lateral split fragment with or without
depression (Fig. 5-A), a posteromedial fragment (Fig. 5-B), a tibial tubercle fragment (Fig. 5-C),
and zones of comminution including the tibial spine (Fig. 5-D).

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

Positive (red) and negative (blue) associations between the main fracture features and Schatzker
types, and among the main fracture features, with the dark colors indicating significant
correlations.

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

Schematic representation of the four main features of tibial plateau fractures in a right tibial
plateau (cranial view).

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.

Two examples of the continuous spectrum of posteromedial fracture lines ranging from parallel
(star in Fig. 8-A) to anteroposterior (star in Fig. 8-B) with respect to the posterior femoral
condylar axis.

Rik J. Molenaars et al. J Bone Joint Surg Am 2015;97:15121520

2015 by The Journal of Bone and Joint Surgery, Inc.