REVIEWS   

Minerva Ortopedica e Traumatologica 2005 October;56(5):457-63

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

Tibial plateau fractures. A review of classifications

Bonasia D. E. ¹, Rossi R. ¹, Bardelli A. ²

¹ Department of Orthopedics and Traumatology University of Turin Umberto I Mauriziano Hospital, Turin, Italy 2 Savigliano City Hospital, Savigliano (Cuneo), Italy

Tibial plateau fractures are a frequent pathology of the knee. They make up 1% of all fractures and 8% of fractures in the elderly. About 40 years ago the only therapeutic option for the tibial plateau fractures was cast immobilization, with or without skeletal traction. The results of this treatment were poor and the complications (instability, stiffness, malalignment, non-anatomical reduction, post-traumatic osteoarthritis) nearly always noticeable. Authors noted that the goal of treatment was anatomic reduction and early knee joint mobilization and that it could be reached almost only by surgical treatments, developing new techniques, with good long-term results. Simultaneously, the need to make new fracture classification schemes grew up, so that each fracture could be related to the most indicated therapy. Many authors (e.g. Hohl, Muller, Schatzker, Moore) proposed their classification. In the literature there are many schemes, each with different features. Hence, we identified the features required from a complete classification: wide diffusion, completeness, simplicity, easiness in memorization, correlation with prognosis and therapy. The aim of this review is to show the most useful classification schemes, considering all those found in the literature. Selecting a standard in the classification allows surgeons to compare the trials and to find the therapy that best fits each type of fracture.