Classifications in Brief: Schatzker Classification of Tibial Plateau Fractures

Excerpt

Early attempts at classifying tibial plateau fractures by Palmer in 1951 [25], Hohl and Luck in 1956 [15], and Hohl in 1967 [15] recognized some of the major themes common to many classification systems for these fractures: split of a condyle, subchondral depression, and comminuted bicondylar involvement. Schatzker et al. published their classification system in 1979 [29], deriving it from the AP radiographs of a series of 94 patients, most of whose tibial plateau fractures were treated nonoperatively [34]. They divided tibial plateau fractures into six types (Fig. 1): split fracture of the lateral tibial plateau (Type I), split depression of the lateral tibial plateau (Type II), central depression of the lateral plateau (Type III), split of the medial tibial plateau (Type IV), bicondylar tibial plateau fracture (Type V), and dissociation between the metaphysis and diaphysis (Type VI; also known as a Type C articular fracture in the AO/OTA classification). The first types involve only the lateral tibial plateau. Type III (depression) fractures were caused by low-energy injuries in osteopenic bone whereas all other types resulted from high-energy injuries [29]. Types IV to VI often result from motor vehicle collisions, motorcycle collisions, and falls from a height [1]. Finally, although the first four types are unicondylar fractures, Types V and VI are bicondylar.

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