Lateral tibial plateau fracture depression as a predictor of lateral meniscus pathology

The goal of this study was to determine if the degree of lateral tibial plateau fracture depression on computed tomography (CT) images predicted the presence of lateral meniscus tears. The study group comprised 85 patients who sustained a lateral tibial plateau fracture and underwent open reduction and internal fixation by the same surgeon. Degree of plateau depression was measured in millimeters by CT. Operative reports were retrospectively reviewed to determine if the lateral meniscus tear was intact or torn at the time of surgery. Twenty-eight patients had a lateral meniscus tear noted at the time of surgery. No significant differences existed in gender, mechanism or energy level of injury, Schatzker classification, or type of fracture among patients with a lateral meniscal tear as compared to those without a tear. Patients with > or =10 mm of plateau depression had an eight-fold increase in risk of having a lateral meniscus tear compared to those with <10 mm of depression. Patients younger than 48 years had a four-fold increase in risk of having a lateral meniscus tear than older patients.This study demonstrated an association between the amount of tibial plateau depression and the likelihood of a lateral meniscus tear. These findings may be used to predict those who have sustained a tear of the lateral meniscus and to advise the surgeon to prepare for a repair. Further prospective studies using magnetic resonance imaging as a tool to evaluate the extent of soft tissue injuries in plateau fractures is needed.