IS Case 596: Schatzker 6 fracture

Nadia F. Yusaf, MD

Imaging Sciences URMC

Imaging Sciences URMC 2010
Publication Date: 2011-11-17

History

Patient is a 35-year-old female who slipped and fell in her kitchen. She immediately had pain in her knee and was unable to bear weight.

Findings

Comminuted proximal tibia fracture which involves the tibia plateau.

Diagnosis

Schatzker 6 fracture

Discussion

The Schatzker classification divides tibial plateau fractures into six types: lateral plateau fracture without depression (type I), lateral plateau fracture with depression (type II), compression fracture of the lateral (type IIIA) or central (type IIIB) plateau, medial plateau fracture (type IV), bicondylar plateau fracture (type V), and plateau fracture with diaphyseal discontinuity (type VI). Schatzker IV fractures represent 20% of tibial plateau fractures. These fractures are due to high energy injury. There is usually extensive soft tissue damage and risk of compartment syndrome. Since there is dissociation between the metaphysis and the diaphysis, this fracture cannot be treated with traction. Management is dependent on the degree of soft tissue damage. CT and MRI are better than radiographs at classifying the type of tibial plateau fracture and also can help with surgical planning.

References

1. Markhardt BK, Gross JM, Monu JU. Schatzker classification of tibial plateau fractures: use of CT and MR imaging improves assessment. Radiographics. 2009 Mar-Apr;29(2):585-97. PMID: 19325067