What is the Radiographic Factor Associated with Meniscus Injury in Tibial Plateau Factures? Multicenter Retrospective (TRON) Study

PurposeTibial plateau fracture (TPF) is a complex intra-articular injury involving comminution and depression of the joint, which can be accompanied by meniscal tears. The aims of this study were (1) to demonstrate the rate at which surgical treatment for lateral meniscal injury and (2) to clarify the explanatory radiographic factors associated with meniscal injury in patients with TPF.MethodsWe extracted the patients who received surgical treatment for TPF from our multicenter database (named TRON) included from 2011 to 2020. We analyzed 79 patients who were received surgical treatment for TPF with Schatzker type II and III and evaluation for meniscal injury on arthroscopy. We investigated the rate at which surgical treatment of the lateral meniscus was required in patients with TPF and the explanatory radiographic factors associated with meniscal injury. Radiographs and CT scans were evaluated to measure the following parameters: tibial plateau slope, distance from lateral edge of the articular surface to fracture line (DLE), articular step, and width of articular bone fragment (WDT). Meniscus tears were classified according to whether surgery was necessary. The results were analyzed by multivariate Logistic analyses.ResultsWe showed that 27.7% (22/79) of cases of TPF with Schatzker type II and III had lateral meniscal injury that required repair. WDT >= 10 mm (odds ratio 10.9; p=0.005) and DLE >= 5 mm (odds ratio 5.7; p=0.05) were independent explanatory factors for meniscal injury with TPF.ConclusionBone fragment size and the location of fracture line on radiographs in patients with TPF are associated with meniscus injuries requiring surgery.

Automated summary

The purpose of this study was to investigate the rate of surgical treatment for lateral meniscal injury in patients with tibial plateau fracture (TPF) and to clarify the explanatory radiographic factors associated with meniscal injury. The results showed that 27.7% of TPF cases required repair for lateral meniscal injury, and bone fragment size and the location of fracture line on radiographs were associated with meniscus injuries requiring surgery.