What is the Radiographic Factor Associated with Meniscus Injury in Tibial Plateau Factures? Multicenter Retrospective (TRON) Study

Keita Naruse; Yasuhiko Takegami; Katsuhiro Tokutake; Keita Shimizu; Yoshito Sudo; Takaaki Shinohara; Shiro Imagama

doi:10.1007/s43465-023-00888-5

What is the Radiographic Factor Associated with Meniscus Injury in Tibial Plateau Factures? Multicenter Retrospective (TRON) Study

Indian J Orthop. 2023 Apr 24;57(7):1076-1082. doi: 10.1007/s43465-023-00888-5. eCollection 2023 Jul.

Authors

Keita Naruse¹, Yasuhiko Takegami¹, Katsuhiro Tokutake², Keita Shimizu¹, Yoshito Sudo¹, Takaaki Shinohara³, Shiro Imagama¹

Affiliations

¹ Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 Japan.
² Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
³ Department of Orthopedic Surgery, Daido Hospital, Nagoya, Japan.

Abstract

Purpose: Tibial plateau fracture (TPF) is a complex intra-articular injury involving comminution and depression of the joint, which can be accompanied by meniscal tears. The aims of this study were (1) to demonstrate the rate at which surgical treatment for lateral meniscal injury and (2) to clarify the explanatory radiographic factors associated with meniscal injury in patients with TPF.

Methods: We extracted the patients who received surgical treatment for TPF from our multicenter database (named TRON) included from 2011 to 2020. We analyzed 79 patients who were received surgical treatment for TPF with Schatzker type II and III and evaluation for meniscal injury on arthroscopy. We investigated the rate at which surgical treatment of the lateral meniscus was required in patients with TPF and the explanatory radiographic factors associated with meniscal injury. Radiographs and CT scans were evaluated to measure the following parameters: tibial plateau slope, distance from lateral edge of the articular surface to fracture line (DLE), articular step, and width of articular bone fragment (WDT). Meniscus tears were classified according to whether surgery was necessary. The results were analyzed by multivariate Logistic analyses.

Results: We showed that 27.7% (22/79) of cases of TPF with Schatzker type II and III had lateral meniscal injury that required repair. WDT ≥ 10 mm (odds ratio 10.9; p = 0.005) and DLE ≥ 5 mm (odds ratio 5.7; p = 0.05) were independent explanatory factors for meniscal injury with TPF.

Conclusion: Bone fragment size and the location of fracture line on radiographs in patients with TPF are associated with meniscus injuries requiring surgery.

Supplementary information: The online version contains supplementary material available at 10.1007/s43465-023-00888-5.

Keywords: Distance from lateral edge of the articular surface to fracture line; Lateral meniscal injury; Tibial plateau fracture; Width of articular bone fragment.

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