Tibial plateau ORIF - Schatzker type III fracture

Displaced fracture of the lateral tibial plateau is observed with lipohaemarthrosis and surrounding soft tissue swelling.

There is a comminutedComminuted, displaced, intra-articular fracture of the proximal tibia. The predominant split, depressed fracture component involves the lateral tibial plateau. A transverse fracture component is also noted at the lateral tibial plateau which extends to the proximal tibiofibular articulation. Lateral displacement of the dominant fracture fragment is also seen. The fracture also involves the tibial spines and interspinous region, with an undisplaced transverse fracture line seen extending into the medial tibial plateau/articular surface.

A comminutedComminuted, displaced, intra-articular fracture of the proximal fibula is additionally noted with involvement of the proximal tibiofibular joint.

Tricompartmental osteoarthritic changes of the knee joint are observed in in the form of marginal osteophytes. Moderate suprapatellar jointbursal effusion is seen.

Interval open reduction and internal fixation (ORIF) of a depressed comminuted fracture of the proximal left tibia is noted. No periprosthetic loosening seen.

Schatzker type III fractures of the tibial plateau are one of the more common types of all tibial plateau fracture typesfractures ¹, involvingdenoting pure depression of the lateral tibial plateau. Of note were the patient's porotic bones resulting in a higher possibility of such an injury occuringoccurring.

Post-operative notes: 

• K wires drilled into fragment for joystick technique

• fracture reduced with bone clamps and held with K wires

• compression plate positioned and held with K wires

• sequential insertion of locking screws done