Department of Orthopedic Surgery, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No. 7 Weiwu Road, Zhengzhou 450003, People's Republic of China.
Arch Orthop Trauma Surg. 2013 Jul;133(7):929-34. doi: 10.1007/s00402-013-1735-4. Epub 2013 Apr 16.
Fractures of the tibial plateau are seen frequently in orthopedic trauma units and traditionally classified based on two-dimension plain radiographs with the Schatzker Classification system, the most popular. This system focuses on fractures involving the medial and lateral plateau but does not comment on fractures that involve the posterior aspect of the tibial plateau. The purpose of this study was to investigate the incidence of posterior tibial plateau fracture and propose a new computed tomography (CT)-based three-column classification system to guide fracture treatment.
Between January 2008 and December 2009, 525 tibial plateau fractures admitted to a level 1 trauma center were retrospectively analyzed by four orthopedic trauma surgeons. Antero-posterior plain radiographs were used for Schatzker classification. CT imaging was used to further classify the fracture types with axial views dividing the plateau into three columns: a lateral, medial, and posterior. Posterior tibial plateau fracture (PTPF) was defined as a fracture with an independent fragment of the posterior column
PTPFs were found in 151 cases and had an incidence of 28.8 % in this studied population. Except for type III, PTPFs were observed in each type of the Schatzker classification system. The Schatzker type VI, V, and IV fractures had the three highest percentages of PTPFs, with 76.1, 51.2, and 22.4 %, respectively.
Fractures of the posterior tibial plateau are not uncommon, especially in high-energy trauma. CT imaging is required to appreciate these fracture patterns, and a three-column classification allows for a better understanding of the fracture morphology and the injury mechanism, which guides surgical management.
在骨科创伤单位中经常会看到胫骨平台骨折，传统上基于二维平片的 Schatzker 分类系统进行分类，该系统最为流行。该系统侧重于涉及内侧和外侧平台的骨折，但不评论涉及胫骨平台后侧面的骨折。本研究的目的是调查胫骨后平台骨折的发生率，并提出一种新的基于计算机断层扫描（CT）的三柱分类系统来指导骨折治疗。
2008 年 1 月至 2009 年 12 月，4 位骨科创伤外科医生回顾性分析了 525 例胫骨平台骨折患者。前后位平片用于 Schatzker 分类。CT 成像用于进一步对骨折类型进行分类，轴位视图将平台分为三柱：外侧、内侧和后侧。胫骨后平台骨折（PTPF）定义为后柱有独立骨折块的骨折。
在该研究人群中，PTPF 病例为 151 例，发生率为 28.8%。除 III 型外，Schatzker 分类系统的每种类型均可见 PTPF。Schatzker 类型 VI、V 和 IV 骨折的 PTPF 比例最高，分别为 76.1%、51.2%和 22.4%。
胫骨后平台骨折并不少见，尤其是在高能创伤中。需要 CT 成像来了解这些骨折模式，三柱分类可以更好地理解骨折形态和损伤机制，从而指导手术治疗。
