“Flip lid” type of lateral tibia plateau fracture with a meniscus radial tear: A case report

Abstract

Case A 45-year-old woman sustained a unique lateral tibia plateau fracture pattern with a vertically rotated fragment composed of an intact articular surface and subchondral bone. During open reduction and internal fixation (ORIF), a full thickness radial tear of the lateral meniscus was found, which was repaired under direct visualization through arthrotomy. At final follow-up, the patient regained pain-free activity with good meniscus healing, as confirmed with a second-look arthroscopic examination. Conclusion This case represents an undescribed fracture pattern that indicates an associated meniscus injury. A thorough evaluation, including Magnetic Resonance Imaging should be considered. One-stage ORIF followed with meniscus repair represents a good treatment option.

“Flipped Lid” Fracture of the Lateral Tibial Plateau with Dislocated Lateral Meniscus

“…It was surprising to see such a large fragment being flipped upside down in a compartment which does not have much space. There was only 1 case 4 reported before who named the fracture “flip lid fracture” because it did not fit into any standard classification systems and was never seen before. Our case differs from theirs in that they had a larger lateral fragment to hold screws, and hence, they fixed the fragment with a plate, and the lateral meniscus in their case had a radial tear.…”

“…We present this case report due to the rarity of the fracture pattern because it does not fit into any classification and to enumerate the importance of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) in planning surgical correction of such “flipped lid” type of fracture (described only once in the literature but different from our case both in fracture pattern and management 4 ) involving the articular surface of lateral tibial plateau.…”