Tibial plateau anterior intercondylar fracture

Case contributed by Dr Bruno Di Muzio

Presentation

Motorcycle accident.

Patient Data

Age: 58-year-old
Gender: Male

Comminuted fracture of the tibial spine. Joint effusion.

MRI

MRI Right knee

There is a fracture of the tibial plateau in the anterior intercondylar area. The anterior cruciate ligament and the anterior root of the lateral meniscus are attached to a displaced anterolateral fragment. There is further minimally displaced osteochondral fragment of the adjacent inner margin of the medial tibial plateau. From this, a fracture line extends posteriorly into the tibial metaphysis but not to the cortex and also medially and laterally.

The posterior root of the medial meniscus is a avulsed at its tibial attachment. No evidence elsewhere of a meniscal tear.

Incomplete mildly depressed fracture through the cortical bone at the anterior aspect of the medial femoral condyle associated with adjacent bone marrow oedema with an overlying articular cartilage injury.

The anterior cruciate ligament is otherwise normal in signal and

morphology. The posterior cruciate ligament and the collateral ligaments are preserved.

Grade 1 chondromalacia of the medial and lateral the sixth of the patella. Moderate joint effusion and extensive subcutaneous oedema anteriorly.

Quadriceps tendon, patella, and patellar tendon are unremarkable. Fluid is seen at the insertion of the medial head of gastrocnemius consistent with a partial insertional tear.

The posterior lateral corner structures are unremarkable.

Case Discussion

There is a fracture of the tibial plateau in the anterior intercondylar area and the anterior cruciate ligament and the anterior root of the lateral meniscus are attached to a displaced anterolateral fragment.

Also, a minimally displaced separate osteochondral fragment of the medial tibial plateau with fracture extension into the proximal tibia. Avulsed posterior root of the medial meniscus.

Focal fracture of the anterior aspect of the medial femoral condyle.

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Case information

rID: 44773
Case created: 4th May 2016
Last edited: 28th May 2016
Tag: rmh
Inclusion in quiz mode: Included

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