This document discusses revisiting the Schatzker classification of tibial plateau fractures. The Schatzker classification has limitations as it does not account for coronal plane fractures or allow for proper planning of postero-medial fragment fixation. CT scans provide more detailed fracture characterization. The authors propose extending the Schatzker classification by using CT scans to further classify fractures based on the location of the main fracture plane in the tibial plateau's four anatomical quadrants. This 3D classification aims to guide surgeons to the area of instability and priorities for addressing stability and congruency.

1. Journal club on
revisiting the schatzker
classification of tibial plateau
(proximal tibia) fracture and its
management
Presented By Dr Pushpendra singh
Rathour(PSR)

3. Schatzker classification :1974

4. Limitations of Schatzker classification
• This classification do not explain coronal plane
fracture.
• All fracture pattern can not be classified on
this.
• Postero-medial fragment fracture fixation
could not be properly planned .
•

5. Aim:
Revisit the Schatzker classification
To examine each fracture type in the light of
information made available by CT scan, which
today comprises a standard and essential tool
in assessing articular fractures.
• The most significant impact and contribution
of three-dimensional imaging in the
assessment of tibial plateau injuries was the
recognition and characterization of fractures.

6. • Extension of the Schatzker classification is
based on plain radiographs in describing the
types and is further complemented by CT to
add the third dimension.
• Plain radiographs allow for the understanding
of the mechanism of injury.
• CT gives us a detailed information about the
exact location of the main fracture plane in
each of the four anatomical quadrants which
we have defined in this paper.

7. The virtual equator of the tibial
plateau

8. CT of tibial plateau

11. Wedge and articular rim intersecting
points
• The points where the wedge, defined by the
principle fracture plane, disrupts the rim are
described in lowercase letters. “a” depicts
anterior, “p” describes posterior. The point
where the fractures exits the metaphyseal
bone is also “a” or “p” but to differentiate, it
gets the addition of an “x”. All letters are
written in lower case.

16. Type 2A

18. Type 3P

19. Type 3P

21. Type 4P

22. Type 4P with PL extension

25. Type 6 (AL+PL+AM+PM)

27. Take home massage
• Three-dimensional classification, which guides
the surgeon to the area of instability, and
stresses the priorities while dealing with
stability and congruency of the tibial plateau
fracture.