ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
From fracture to joint injury: association between CT-based fracture characteristics and surgically treated non-bony injuries in tibial plateau fractures.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTibial plateau fractures (TPF) are often associated with non-bony injuries that may impair knee stability and long-term outcomes. However, it remains unclear in which patients preoperative MRI is indicated to detect these injuries, and clear recommendations for surgical decision making are lacking. This study aimed to develop a CT-based predictor of surgically relevant non-bony injuries.
methodsThis retrospective single-center study included all intra-articular TPF treated between January 2022 and May 2025 at a Level I trauma center. Fractures were classified according to the 10-segment and three-column classifications. Operative reports were reviewed to identify non-bony injuries requiring surgical treatment. Descriptive statistics and multivariate logistic regression were performed to determine predictors of surgically relevant non-bony injuries.
resultsAmong 243 patients (mean age 49,3 ± 14,9 years), 34,6% had at least one surgically treated non-bony injury. Posterior column involvement was significantly associated with a higher injury rate (41,4%), particularly affecting meniscus (20,7%), Anterior cruciate ligament (ACL) (17,2%), and medial collateral ligament (MCL) (12,3%). The posterolateral-central (PLC) segment showed the highest segment-specific injury rate (37,6%) and was an independent predictor of ACL injury. Increasing fracture complexity was associated with a higher incidence of soft tissue injuries.
conclusionTPF should be regarded as complex intra-articular injuries rather than simple bone fractures. This study provides a CT-based tool to identify fracture patterns associated with surgically relevant non-bony injuries. These findings may support indications for preoperative MRI, guide treatment strategies, and help prevent poor outcomes and post-traumatic osteoarthritis.
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