Management of Unicondylar Tibial Plateau Fractures: A Review

Daniel Warren, BS; Grayson Domingue, MD; John T. Riehl, MD

Disclosures

Curr Orthop Pract. 2022;33(1):85-93. 

In This Article

Radiographic Evaluation

Anteroposterior and lateral radiographs centered on the knee tilted caudally 10 degrees to approximate the tibial slope are the standard radiographic views to evaluate injury of the tibial plateau.[52] CT is an important component of radiographic evaluation of tibial plateau injuries. Conventional radiographic evaluation is limited by poor detection of fragments of the posterior column and fracture lines in the coronal plane. The use of CT increases the rate of detection of these injuries[31] and also significantly increases interobserver agreement on fracture classification and treatment plan.[37,39,40] MRI is useful for detecting bony and soft-tissue pathology, but its use in previous literature has not been shown to improve outcomes in the management of these fractures.[34] Recent studies demonstrate MRI is compatible with the pin-to-bar type external fixator that is commonly used in the management of tibial plateau injury.[53] Despite potential advantages to MRI in visualization of soft tissues, indications for MRI in TPF remain unclear.[12,52]

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