Tibial plateau fractures: CT evaluation and classification

Fractures of the tibial plateau consist of two important components. One is depression of the plateau surface and the other a detached and peripherally displaced component referred to as the split fragment. The classification of these fractures is based on the morphologic appearance as well as the location of the above components. The surgical treatment of these fractures is dependent upon several factors, including the type of fracture, the degree of the fracture depression, and fracture fragment separation as well as the patient's age and physical condition. The degree of the plateau depression is a particularly important criteria for surgical-treatment planning. However, the anatomic configuration of the proximal tibia is such that the fractures of these regions are not adequately visualized on conventional radiographs. In the past, conventional tomography was routinely employed for evaluation of tibial plateau fractures. Recently, computed tomography (CT) has shown to be a more accurate and easier method for evaluation of these fractures. CT can be performed without removal of the knee brace or cast and usually requires less than 12 axial images. Furthermore, the degree of fracture separation and depression can be measured by computerized technique. CT scanning is a reliable method for evaluation and an accurate classification of tibial plateau fractures.