Interobserver reliability of the Schatzker and Luo classification systems for tibial plateau fractures

Mellema, Jos J.; Doornberg, Job N.; Molenaars, Rik J.; Ring, David; Kloen, Peter; Babis, George C.; Jeray, Kyle J.; Prayson, Michael J.; Pesantez, Rodrigo; Ramos, Adilson Luiz; Verbeek, Diederik O.; Melvanki, Parag; Kreis, B.E.; Mehta, Samir; Meylaerts, S.A.G.; Wojtek, S.; Yeap, Ewe Juan; Haapasalo, Heidi; Kristan, Anže; Coles, Chad P.; Marsh, J. Lawrence; Mormino, Matthew A.; Menon, M. P. A.; Tyllianakis, Minos; Schandelmaier, P.; Jenkinson, Richard; Neuhaus, Valentin; Shahriar, Chegini M H; Belangero, William Dias; Kannan, Santhana; Leonidovich, Golovakha M.; Davenport, James; Kabir, K.; Althausen, Peter L.; Weil, Yoram A.; Toom, Alar; Costa, Daniel Sá da; Lijoi, Francesco; Koukoulias, Nikolaos E.; Manidakis, Nikolaos; Bogaert, Max Van Den; Patczai, Balázs; Grauls, A.; Kurup, Harish; Bekerom, Michel PJ van den; Lansdaal, J.R.; Vale, Mário; Ousema, Paul; Barquet, Antonio; Cross, Brian; Broekhuyse, Henry M.; Haverkamp, Daniël; Merchant, Milind; Harvey, Edward J.; Pemovska, E. Stojkovska; Frihagen, Frede; Seibert, F. J.; Garnavos, Christos; Heide, H. van der; Villamizar, Harold Alonso; Harris, Ian A.; Borris, Lars C.; Brink, Ole; Brink, Peter R.; Choudhari, Pradeep; Swiontkowski, Marc F.; Mittlmeier, Thomas; Tosounidis, Theodoros H.; Rensen, Inge Van; Martinelli, Nicolò; Park, D. H.; Lasanianos, Nikolaos; Vide, João; Engvall, Andreas; Zura, Robert; Jubel, A.; Kawaguchi, Alan T.; Goost, H.; Bishop, Julius A.; Mica, Ladislav; Pirpiris, Marinis; Helden, Sven H. van; Bouaicha, Samy; Schepers, Tim; Havliček, Tomo; Giordano, Vincenzo

doi:10.1016/j.injury.2015.12.022

Cited by 32 publications

(27 citation statements)

References 42 publications

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“…In addition to this, complex plateau fractures that can be described as Schatzker types V and VI, AO-OTA type C, revised Duparc bicondylar, spinocondylar or posteromedial fractures or Hohl and Moore type V fractures necessitate special attention when management with dual plating. Recently, Luo et al [5] described three column fixations for these kinds of fractures and Mellema et al [9] compared Luo classification with Schatzker. Although they found fair agreement between observers for Schatzker and Luo classifications, we found moderate interobserver and substantial intraobserver agreement for Luo classification.…”

Section: Discussionmentioning

confidence: 99%

Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems

Taşkesen

Demirkale

Okkaoğlu

et al. 2017

Eklem Hastalik Cerrahisi

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Section: Discussionmentioning

confidence: 99%

Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems

Taşkesen

Demirkale

Okkaoğlu

et al. 2017

Eklem Hastalik Cerrahisi

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“…The limitation in this classification system regards the posteromedial fractures with extension to the lateral plateau and isolated postero-medial or postero-lateral involvement. 16 , 20 Moreover Schatzker shows significant better intraobserver reliability. 16 , 20 But agreement was fair for both in their study.…”

Section: Discussionmentioning

confidence: 89%

“… 16 , 20 Moreover Schatzker shows significant better intraobserver reliability. 16 , 20 But agreement was fair for both in their study. 20 …”

Section: Discussionmentioning

confidence: 89%

Tibial plateau fractures: Fracture patterns and computed tomography evaluation of tibial plateau fractures in winter sports

Gebel¹,

Tryzna²,

Beck³

et al. 2018

Orthop Rev (Pavia)

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The purpose was to analyze tibial plateau fractures (TPF) by computed tomography (CT) by creating a frequency map (FM). We hypothesized that a FM shows clinically important aspects of involvement that are not expressed in classic classifications. 185 TPF were retrospectively evaluated in this single center study. We created a FM onto an axial template of an intact subarticular tibial plateau and separated the joint surface in 9 areas, counted the frequency of involvement. The FM gives information of location and grade of damage and expressed three major fracture areas in 76%. 5 specific fracture types add up to 51%. The dorsal parts of the tibial plateau are involved in a higher percentage (+8%). True lateral fractures are less often than plane radiographs suggest. An impression was found in 50%. The complexity of TPFs is high, but 5 specific types could be identified in >50%. The complexity is not sufficiently covered in common classifications, especially the dorsal involvement. The FM is a simple and useful tool that complements common classifications and can be used as guideline for surgical treatment.

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“…Dies unterstreicht die Notwendigkeit einer adäquaten Klassifikation und eines adäquaten Behandlungsansatzes von posterioren Pfeilerfrakturen. Die 2010 von Luo et al [5] eingeführte Drei-Pfeiler-Klassifikation hat sich als sehr nützliches und reliables Instrument für die präoperative Behandlungsplanung von Tibiaplateaufrakturen erwiesen, insbesondere bei Beteiligung des posterioren Pfeilers [6][7][8]. Außerdem unterstützt die angepasste Drei-Pfeiler-Klassifikation den Chirurgen in Zugangs-und Implantatauswahl bei der Behandlung von Mehrpfeilerfrakturen auf Basis des Unfallmechanismus und der Frakturmorphologie [9].…”

Section: Methodsunclassified

Der kombinierte posteromediale und anterolaterale Zugang in der „floating“-Position zur operativen Versorgung der Zwei-Pfeiler-Tibiakopffraktur

Reul

Hoekstra

2017

Z Orthop Unfall

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The posterior tibial plateau is often affected in intra-articular tibial fractures. Moreover, treating these posterior fractures is recognised as an important prognostic factor. Open reduction and internal fixation of lateral and posterior two column tibial plateau fractures can be achieved via a combined reversed L-shape approach and an anterolateral approach in the floating position without intraoperative repositioning of the patient. The operative procedure starts in the posterior position with visualisation of the posterior column after lateral retraction of the medial head of the M. gastrocnemius. The posterior fragment is then reduced and fixated. This is followed by reversed patient tilt, and slight flexion and varus stress on the knee. An anterolateral approach is performed with visualisation of the lateral column, direct reduction and internal fixation of the lateral tibia plateau. Since June 2014, 14 two column tibial plateau fracture patients with posterior and lateral column involvement have been treated according to this technique. The median follow-up was 306 days (IQR 194 - 438); 1 patient was lost to follow-up. During the last outpatient visit, 7 patients reported pain to some extent. At a median of 110 days (IQR 96 - 181), 10 patients showed a full range of motion. One deep infection was noted postoperatively. At the 3 to 4 month postoperative CT control, 10 of 14 patients showed successful reduction with restored alignment, whereas in 8 of 14 patients there was a congruent articular surface without significant articular steps (< 2 mm). We have demonstrated that the surgical treatment of two column fractures of posterior and lateral tibial plateau fractures is technically possible via a combined posterior reversed L-shaped and anterolateral approach in a floating position without the necessity of intraoperatively repositioning of the patient. Although the number of patients was limited, the clinical and radiographic outcome was rather good.

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Interobserver reliability of the Schatzker and Luo classification systems for tibial plateau fractures

Cited by 32 publications

References 42 publications

Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems

Intraobserver and interobserver reliability assessment of tibial plateau fracture classification systems

Tibial plateau fractures: Fracture patterns and computed tomography evaluation of tibial plateau fractures in winter sports

Der kombinierte posteromediale und anterolaterale Zugang in der „floating“-Position zur operativen Versorgung der Zwei-Pfeiler-Tibiakopffraktur

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