Treatment of Lateral Tibial Plateau Impaction Fracture

Initial Diagnostic Workup

• Obtain CT imaging after radiographic diagnosis to fully characterize fracture severity, classify the injury pattern, and predict associated soft tissue injuries, as recommended by the American College of Radiology 1, 2
• CT demonstrates 100% sensitivity versus 83% for radiographs in detecting tibial plateau fractures and is superior for characterizing fracture severity, according to the American College of Radiology 1
• Lateral tibial plateau depression >11 mm on CT predicts higher risk of lateral meniscus tears and ACL avulsion fractures, which should prompt consideration for MRI, as suggested by the American College of Radiology 1, 2
• MRI is the next best imaging modality when suspecting additional radiographically occult fractures or internal derangements, given its superior evaluation of meniscal and ligamentous injuries, as recommended by the American College of Radiology 1, 2

Postoperative Management

• Initiate functional rehabilitation with motion restoration and strengthening exercises rather than prolonged immobilization, as recommended by Praxis Medical Insights 3