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Preoperative CT can help determine best fixation strategy for posterolateral fragment
Preoperative CT measurement can be used for determining the best fixation strategy for posterolateral fragment in lateral and bicondylar tibial plateaus, according to researchers.
During a retrospective chart review, the researchers identified 190 patients with Orthopaedic Trauma Association type B and type C tibial plateau fractures who underwent CT scans before surgery to determine the incidence of morphologic characteristics of posterolateral fragments. The lateral major articular fracture angle, posterior major articular fracture angle, diagonal distance, lateral anteroposterior distance, posterior horizontal distances, posterior cortical height, sagittal fracture angle and articular surface area were included in the parameters for the morphologic evaluation. The researchers measured the displacement of posterolateral fragment on axial image and classified it as none, minor or major by a gap of 5 mm.
Overall, 44.2% of cases were included in the incidence of posterolateral fragments. The researchers identified type B posterolateral fragments in 35.9% of patients and type C in 54% of patients.
Results showed a mean lateral major articular fracture angle of 12.69° and a mean posterior major articular fracture angle of 19.13°. The researchers calculated an average diagonal distance of 32.75 mm, as well as an average lateral anteroposterior distance of 10.22 mm and a mean posterior horizontal distance of 22.93 mm.
The average posterior cortical height calculated was 31.21 mm, whereas the average sagittal fracture angle was 78.48°. Additionally, mean articular surface area of the total tibial articular surface was 522.18 mm2, according to the researchers. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.