Soft tissue injury prediction using joint depression in computed tomography in AO 41B lateral tibial plateau fractures

Abstract

Tibial plateau fractures are usually associated with soft tissue injury. This study aimed to use the extent of joint depression and lateral widening in computed tomography (CT) to predict the soft tissue injury accompanying fractures.The study included 23 patients with type Arbeitsgemeinschaft für Osteosynthesefragen-classified 41B fractures. Demographics, mechanism of injury, age, gender, and injury sites were assessed. Post-traumatic radiography, magnetic resonance imaging (MRI), and CT were obtained. MRI evaluated the meniscal, cruciate, and collateral ligament injuries, and CT measured the extent of joint depression and lateral widening in millimeters using digital imaging software. The relationship between joint depression, lateral widening, and soft tissue injuries was statistically analyzed. Of the 23 patients, 17 (74%) were males and 6 (26%) were females. Lateral meniscus injuries increased and the risk of bucket handle lateral meniscus tears increased as the CT joint depression exceeded 12 mm (p < 0.05). Joint depression of <5.9 mm was associated with medial meniscus injury (p < 0.05). The mean distribution examination of all soft tissue injuries and joint depression revealed no statistically significant difference between the groups (p > 0.05). Increased joint depression in lateral tibial plateau fractures increases the risk of lateral meniscus bucket handle tear, and decreased joint depression increases the risk of medial meniscus injury. Accordingly implementing the treatment plan and patient management will improve the clinical outcomes.