Schatzker Classification of Tibial Plateau Fractures

The Schatzker classification divides tibial plateau fractures into six types:

Type (%)	Definition	Associated injuries
I (6%)	Lateral plateau fracture without displacement and with less than 4 mm of depression1	May be associated with a distraction-type injury to the medial collateral ligament or anterior cruciate ligament
II (25%)	Lateral plateau fracture with greater than 4 mm of depression	20% of patients have associated distraction injuries to the medial collateral ligament or medial meniscus
IIIA	Compression fracture of the lateral plateau
IIIB	Compression fracture of the central aspect of the tibial plateau	May result in joint instability
IV (10%)	Medial plateau fracture with a split or depressed component	Worst prognosis. Increased likelihood of injury to the peroneal nerve or popliteal vessels. Frequently associated with distraction injury to the lateral compartment2
V (3%)	Bicondylar plateau fracture (wedge fractures of the medial and lateral tibial plateau	Articular depression typically seen in lateral plateau. May see associated fracture of the intercondylar eminence. 50% have peripheral meniscal detachment. 30% have anterior cruciate ligament avulsion injury. Status of soft tissues dictates management.
VI (20%)	Transverse subcondylar fracture with dissociation of the metaphysis from the diaphysis	30% are open. There is frequently extensive soft-tissue injury. Increased risk of compartment syndrome. Status of soft tissues dictates management.

¹ Lateral tibial plateau depression is measured as the vertical distance between the lowest point on the intact medial plateau and the lowest depressed lateral plateau fracture fragment
² e.g., lateral collateral ligament complex injury, posterolateral corner injury, or fracture or dislocation of proximal fibula

References

Markhardt BK, Gross JM, Monu J. Schatzker Classification of Tibial Plateau Fractures: Use of CT and MR Imaging Improves Assessment. RadioGraphics 2009 29:585-597.