Shimin Zhang1, Sunjun Hu2, Shouchao Du2, Zhuo Ma2. 1. Department of Orthopedics, Yangpu Hospital, Tongji University, Shanghai, 200090, P.R.China.shiminchang11@aliyun.com. 2. Department of Orthopedics, Yangpu Hospital, Tongji University, Shanghai, 200090, P.R.China.
Abstract
Objective: To summarize the progress in the treatment of hyperextension tibial plateau fractures. Methods: Related literature concerning hyperextension tibial plateau fractures was reviewed and analyzed in terms of injury mechanisms, clinical patterns, and treatment outcomes. Results: Hyperextension tibial plateau fractures is a specific type of hyperextension knee injuries, which is happened with the knee in over-extended position (<0°) and characterized by fracture and concomitant ligament injury. It can be classified into 4 patterns: marginal avulsion fractures, unicondylar anteromedial fractures, anterolateral fractures, and bicondylar fractures. The failure of structures occurs according to the diagonal injury mechanism characterized by anterior compression fractures and posterior tension ruptures. It is noted as a rule that a smaller anterior fragment is more likely to accompany by a posterior ligament rupture. Unicondylar anteromedial fracture pattern is caused by hyperextension varus mechanism and usually accompanied by posterolateral corner rupture. Bicondylar hyperextension injury is characterized by posterior metaphyseal cortical tension rupture, anterior articular depression, and reversed posterior slope. Conclusion: Currently there is no consensus on the treatment of hyperextension tibial plateau fractures. Further basic and clinical studies are needed.
Objective: To summarize the progress in the treatment of hyperextension tibial plateau fractures. Methods: Related literature concerning hyperextension tibial plateau fractures was reviewed and analyzed in terms of injury mechanisms, clinical patterns, and treatment outcomes. Results:Hyperextension tibial plateau fractures is a specific type of hyperextension knee injuries, which is happened with the knee in over-extended position (<0°) and characterized by fracture and concomitant ligament injury. It can be classified into 4 patterns: marginal avulsion fractures, unicondylar anteromedial fractures, anterolateral fractures, and bicondylar fractures. The failure of structures occurs according to the diagonal injury mechanism characterized by anterior compression fractures and posterior tension ruptures. It is noted as a rule that a smaller anterior fragment is more likely to accompany by a posterior ligament rupture. Unicondylar anteromedial fracture pattern is caused by hyperextension varus mechanism and usually accompanied by posterolateral corner rupture. Bicondylar hyperextension injury is characterized by posterior metaphyseal cortical tension rupture, anterior articular depression, and reversed posterior slope. Conclusion: Currently there is no consensus on the treatment of hyperextension tibial plateau fractures. Further basic and clinical studies are needed.