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Lower incidence of meniscal tears with tibial plateau fractures found intraoperatively

Issue: November 2012

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MINNEAPOLIS – Investigators discovered that nearly a third of patients with tibial plateau fractures had intraoperatively detected meniscal tears, according to a study presented here.

“Clinically relevant, following tibial plateau fractures is a 31% incidence of associated meniscal tears. This is lower than the preoperative imaging studies, such as MRI, that have been published in the past,” Daniel L. Stahl, MD, from the Florida Orthopedic Institute in Tampa, said at the Orthopaedic Trauma Association Annual Meeting 2012. “Most of these [tears] are associated with Schatzker 2 fracture morphology, and a majority of these meniscal tears were for peripheral longitudinal tears.”

 

Daniel L. Stahl

Stahl and colleagues performed a retrospective review of all skeletally mature patients with tibial plateau fractures operatively treated between 2002 and 2011. The investigators studied the operative notes for the patients, CAT scans and radiographs, and determined fracture type based on OTA and Schatzker classifications. They also noted the incidence of intraoperatively detected meniscal tears and their type when recorded. Patients who had surgical stabilization performed subcutaneously or operative reports that did not mention meniscal arthrotomy were excluded from the study.

Of the 651 patients included in the study, 204 (31%) had meniscal tears.

“The majority of these were peripheral longitudinal tears (53%), and the second were bucket handle tears at 30%,” Stahl said.

The investigators found a significant correlation between meniscal tear and Schatzker type 2 fractures. Although they discovered no significant difference between the rate of tears seen with OTA A and B fractures, they found that 35% of tears were in OTA type 41B fractures.

Reference:

Stahl DL, Serrano-Riera R, Deafenbaugh B, et al. The incidence of meniscal tears requiring repair in tibial plateau fractures: A review of 670 patients. Paper #78. Presented at the Orthopaedic Trauma Association Annual Meeting 2012. Oct. 3-6. Minneapolis.

Disclosure: Stahl has no relevant financial disclosures.