CT of Periarticular Adult Knee Fractures: Classification and Management Implications

Area of Science:

• Orthopedic surgery
• Radiology
• Trauma care

Background:

• Periarticular knee fractures (distal femur, tibial plateau, patella) are common, complex injuries (5%-10% of trauma center cases).
• These fractures often involve the articular surface, requiring precise surgical reconstruction for functional knee biomechanics.

Purpose of the Study:

• To provide a comprehensive CT imaging guide for periarticular knee fractures.
• To enhance communication between radiologists and orthopedic surgeons by linking CT findings to surgical decision-making.
• To promote standardized, clinically relevant reporting of these complex fractures.

Main Methods:

• Utilizes computed tomography (CT) with multiplanar reformats and volume rendering for detailed fracture assessment.
• Classifies distal femur and patellar fractures using the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) system.
• Grades tibial plateau fractures using the Schatzker system and the CT-based three-column concept.

Main Results:

• CT findings correlate fracture patterns with necessary surgical approaches, bone grafting needs, and hardware selection.
• Identifies bony avulsive patterns indicative of associated ligamentous injuries, guiding early stress testing.
• Facilitates optimized surgical planning to restore limb alignment, length, and rotation, minimizing risks like osteoarthritis.

Conclusions:

• A standardized CT approach improves the management of periarticular knee fractures.
• Accurate interpretation of CT scans is crucial for successful surgical reconstruction and functional recovery.
• This primer aids in optimizing surgical outcomes by clarifying the relationship between fracture morphology and treatment strategies.