Objective The goal of this study was to determine the incidence of soft-tissue injuries in patients with posterolateral tibial plateau fractures. Methods The data of 265 patients who had sustained posterolateral tibial plateau fractures between May 2009 and Aug 2014 were retrospectively reviewed using a picture archiving and communication system. Fractures were classified according to the Schatzker, AO/OTA, and quadrant classification systems. Soft-tissue injuries, including anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL), medial collateral ligament (MCL), lateral meniscus, and medial meniscus injuries, were assessed using magnetic resonance imaging (MRI) data. Results The overall incidence of ACL and PCL tears was 80 and 36%, respectively. Nine (36%) patients sustained ACL footprint avulsions and three (12%) had complete ACL tears. A total of 19 (76%) patients had LCL injuries, and 15 (64%) had MCL injuries. The incidence of lateral meniscus tears was 48%, while that of medial meniscus tears was 4%. Conclusion Posterolateral tibial plateau fractures were associated with a high incidence of soft-tissue injuries, especially ACL footprint avulsions and lateral meniscus tears. The preoperative MRI examination was important for surgeons to decide whether the ligament and meniscal injuries should be treated simultaneously with the repair of the bone fractures.
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