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ortho-trauma

Schatzker Classification of Tibial Plateau Fractures

Six-type classification of tibial plateau fractures (Schatzker 1979). Higher type = greater energy and worse prognosis.

Score interpretation

Type I 1

→ Often percutaneous lag-screw fixation if depression <3 mm. Hinge knee brace 6 weeks; toe-touch weight-bearing.

Types II–III 2–3

→ ORIF with elevation of depression and bone graft / substitute. CT pre-op essential. Non-weight-bearing 6–8 weeks.

Type IV — Medial 4

→ High-energy injury with high-risk neurovascular involvement. Check ABI, peroneal nerve. ORIF dual-plate; consider external fixation if soft tissue compromised.

Types V–VI — Bicondylar / dissociation 5–6

→ Damage-control orthopaedics: spanning external fixator until soft tissues settle (often 1–2 weeks). Definitive dual-plate ORIF or hybrid frame. High rate of complications (compartment syndrome, infection, post-traumatic OA).

Interpretation bands for the Schatzker. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.