Analysis of the types of lateral meniscal injury in Schatzker type II tibial plateau fractures and its correlation with CT features of lateral plateau
10.3760/cma.j.cn121113-20210829-00532
- VernacularTitle:SchatzkerⅡ型胫骨平台骨折外侧半月板损伤类型及其与外侧平台CT表现的相关性
- Author:
Pu YING
1
;
Xuan WANG
;
Yue XU
;
Yiwen ZHAO
;
Kejie WANG
;
Xiaowei JIANG
;
Zhihui HUANG
;
Wenge DING
;
Qiang WANG
;
Xiaoyu DAI
Author Information
1. 南京中医药大学常熟附属医院骨科，常熟 215500
- Keywords:
Tibial fractures;
Tibial meniscus injuries;
Tomography, X-ray computed
- From:
Chinese Journal of Orthopaedics
2022;42(14):912-919
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.
