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Review Question - QID 8923

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QID 8923 (Type "8923" in App Search)
Which of the following concerning meniscus tears in tibial plateau fractures is true?

Lateral meniscus tears are most common and occur with Schatzker II fractures. Open evaluation with division of the meniscotibial ligaments is recommended

66%

1751/2636

Lateral meniscus tears are most common and occur with Schatzker III fractures. Open evaluation with division of the meniscofemoral ligaments is recommended

12%

322/2636

Lateral meniscus tears are most common and occur with Schatzker I fractures. Open evaluation with division of the meniscotibial ligaments is recommended

2%

43/2636

Medial meniscus tears are most common and occur with Schatzker II fractures. Open evaluation with division of the meniscotibial ligaments is recommended

2%

42/2636

Lateral meniscus tears are most common and occur with Schatzker II fractures. These do not require acute treatment.

17%

458/2636

Select Answer to see Preferred Response

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Lateral meniscal tears occur most commonly in young males with a lateral split-depression tibial plateau fracture. In these cases, a submeniscal arthrotomy with direct mensical evaluation should be performed to evaluate necessity for repair.

These tears occur most frequently in young males, with peripheral rim tears most commonly associated with split depression fractures. Surgical treatment of the meniscal tear occurs after fracture is reduced and fixation complete with an anterolateral approach. The joint is then exposed and the meniscus evaluated.. For longitudinal tears meniscal repair should be performed. Radial tears can be partially resected, but in rare cases, these can be repaired as well.

Stahl et al. reviewed the operative notes and radiographs of 602 adults to determine type of tibial plateau fracture, mechanism of injury, intraoperative detection of a lateral meniscal tear, and operative repair/partial resection of the meniscus itself. Lateral meniscal tears requiring operative repair were detected intraoperatively in 179 patients (30%). This could be broken down into 12% for pure lateral split fractures, 45% for split depression fractures (P < 0.001), 18% for pure depression fractures, 22% for bicondylar fractures, and 26% for intra-articular plus shaft fractures.

Ruiz-Ilban et al. performed a study to determine the results of repair of meniscal tears found during arthroscopically assisted reduction and internal fixation (ARIF) of tibial plateau fractures. In a cohort of 51 tibial plateau fractures treated with ARIF, 15 associated meniscal tears (15 knees) in 14 patients were repaired. A second-look arthroscopy was performed in 13 knees a mean of 14.2 months after the initial surgery. All patients had good or excellent clinical results. Second-look arthroscopy confirmed complete healing in 92% of meniscal tears when performed.

Illustration A shows an AP radiograph of a split-depression lateral tibial plateau fracture (Schatzker II). Illustration B shows and MRI image of a bicondylar tibial plateau fracture with incarcerated and torn lateral meniscus

Incorrect Answers:
Answer 2: Lateral meniscus tears are more common with Schatzker II fractures
Answer 3: Lateral meniscus tears are more common with Schatzker II fractures
Answer 4: Lateral meniscal tears are more common than medial with Schatzker II fractures
Answer 5: Lateral meniscal tears may benefit from acute treatment at the time of fracture fixation.

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