Presentation
Tripped and fell, sustaining a rotational injury to the left knee.
Patient Data
Age: 20 years
Gender: Female
From the case:
Tibial plateau fracture: Schatzker type V
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Tibial plateau fracture on both sides of the eminence, the medial is split and the lateral has a depressed component - Schatzker type V fracture. The eminence is shattered and detached.
Pneumolipohaemarthrosis in the suprapatellar bursa.
From the case:
Tibial plateau fracture: Schatzker type V
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Comminuted tibial plateau fracture with detachment of the intercondylar eminence and medial depression - Schatzker type V fracture.
The patella is in pronounced lateral tilt and subluxation.
Large lipohemarthrosis.
The patella is in pronounced lateral tilt and subluxation.
Large lipohemarthrosis.
Medial meniscus: normal height and signal.
Lateral meniscus: detached (meniscocapsular separation), flipped, translated to the center of the knee, probably impacted in the plateau fracture.
Anterior cruciate ligament (ACL): normal thickness, course and signal; of note, detachment of the eminence with the ACL insertion.
Posterior cruciate ligament (PCL): normal thickness, course and signal.
Lateral meniscus: detached (meniscocapsular separation), flipped, translated to the center of the knee, probably impacted in the plateau fracture.
Anterior cruciate ligament (ACL): normal thickness, course and signal; of note, detachment of the eminence with the ACL insertion.
Posterior cruciate ligament (PCL): normal thickness, course and signal.
Medial collateral ligament (MCL): normal thickness, course and signal.
Lateral collateral ligament (LCL): normal thickness, course and signal.
Lateral collateral ligament (LCL): normal thickness, course and signal.
Quadriceps tendon: normal thickness, course and signal.
Layers of muscle, fat planes, skin, and subcutaneous tissue: prominent edema.
In summary:
- Complex tibial plateau fracture (Schatzker V)
- Detachment of the intercondylar eminence with the ACL insertion
- Lateral menscus separation, translation to the center of the knee and apparent impaction between the fracture fragments
- Lateral tilt and subluxation of the patella
- Substantial lipohemarthrosis
Case Discussion
CT and MRI features of a Schatzker type V fracture with lateral meniscocapsular separation.
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