How are tibial plateau fractures identified on radiographs?

Updated: Apr 20, 2020
  • Author: Srinivasa Vidyadhara, MBBS, DNB, MS(Orth), DNB(Orth), FNB(SpineSurg), MNAMS; Chief Editor: Thomas M DeBerardino, MD  more...
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For a discussion of the challenges in radiologic diagnosis and evaluation of tibial plateau fractures, see Dennan. [11]


Most tibial plateau fractures are easy to identify on standard anteroposterior (AP) and lateral projections of the knee. Lateral views should not be considered adequate if a rotational component obscures the visualization of the femoral condyles as a single unit. Rotational malalignment can lead to missed zones of injury and an inaccurate estimation of the degree of articular depression.

With minimally displaced vertical split fractures, the fracture line often lies in an oblique plane and is therefore not visible on an AP or lateral radiograph. Oblique projections should be added if a nondisplaced tibial plateau fracture is suspected but not seen on the standard projections.

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