Classification of tibia plateau fracture according to the "four-column and nine-segment"
10.3760/cma.j.cn115530-20191127-00429
- VernacularTitle:胫骨平台骨折的四柱九区分型体系
- Author:
Xiang YAO
1
;
Yong XU
;
Jishan YUAN
;
Bin LYU
;
Xingli FU
;
Lei WANG
;
Shengquan YANG
;
Sheng MENG
Author Information
1. 江苏省江苏大学附属人民医院骨科，江苏省镇江市 212002
- From:
Chinese Journal of Orthopaedic Trauma
2020;22(8):665-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To characterize tibial plateau fractures using a computed-tomography-based "four-column and nine-segment" classification.Methods:A retrospective analysis was conducted of the 698 adult patients with tibial plateau fracture (704 knees) who had been admitted to Department of Orthopedics, The Affiliated People's Hospital of Jiangsu University from December 2007 to May 2018. They were 377 males and 321 females with an average age of 51.6 years. The left knee was affected in 371 cases (53.2%), the right knee in 321 cases (46.0%) and bilateral knees in 6 cases (0.9%). According to the differentiated morphological characteristics, the tibial plateau and proximal fibula were divided into 4 columns, which were subdivided into 9 segments. Tibial plateau injury index (TPII) was innovatively introduced to represent the extent of injury. Fracture mapping was retrospectively analyzed according to the "four-column and nine-segment" classification based on the CT imaging.Results:The rates of one-column, two-column, three-column and four-column injuries were 30.5% (215/704), 31.5% (222/704), 28.0% (197/704), and 9.9% (70/704), respectively. On average, 2.2 columns ± 1.0 columns and 3.6 segments ± 2.1 segments were affected in each case. The mean TPII was 5.7±3.0. The rates of mild, moderate and severe comminuted fractures were 50.0% (352/704), 37.5% (264/704), and 12.5% (88/704). The columns most frequently affected were the lateral column (572, 81.3%) and the intermedial column (524, 74.4%) while the less frequently involved ones the medial column (219, 31.1%) and the fibular column (218, 31.0%). The sequence of the segments affected was the posterolateral segment (465, 66.1%), the anterolateral segment (453, 64.3%), the posteromedian segment (379, 53.8%) and the tubercle segment (85, 12.1%).Conclusions:The novel "four-column and nine-segment" classification may be a beneficial system for clinical diagnosis, statistical analysis and prognostic judgment of tibial plateau fractures.
