Analysis of Missed Diagnosis of Schatzker Type Ⅳ Tibial Plateau Fracture with Anterior Cruciate Ligament Rupture
ZHANG Peng
XIAO Yi
XIE Wenpeng
Abstract：Objective To investigate the clinical characteristics,causes of missed diagnosis and preventive measures of Schatzker type Ⅳ tibial plateau fracture with anterior cruciate ligament rupture.Methods The clinical data of 13 patients with Schatzker type Ⅳ tibial plateau fracture with anterior cruciate ligament rupture,which had been missed in our hospital from January to December 2022,were retrospectively analyzed.Results All patients were treated in the Emergency Depart-ment after injury.X-ray or CT examination of the knee joint was performed to diagnose Schatzker type Ⅳ tibial plateau frac-ture.All cases underwent open reduction and internal fixation of tibial plateau fracture.After the fracture healed well,she was admitted to hospital for internal fixation and complained of instability of the knee joint.After knee MRI examination combined with medical history,she was diagnosed with anterior cruciate ligament rupture,and the symptoms of three patients were sig-nificantly reduced after conservative treatments.Ten patients underwent anterior cruciate ligament reconstruction,knee flexion(109.40±13.55)° at1 month after surgery,Lysholm knee joint score(83.77±6.80)score,and International Knee Joint Scoring Committee score(80.38±9.51)score.The missed diagnosis lasted11 to17(13.10±1.79)months.Conclusion Schatzker typeⅣtibial plateau fracture with anterior cruciate ligament rupture is more likely to be missed.Special attention should be paid to the soft tissue injury around the knee joint during the clinical examination of patients similar to those de-scribed in this article.MRI of the knee joint should be routinely performed,knee arthroscopy can be assisted during the opera-tion,and physical examination under anesthesia after fracture fixation is completed to reduce or avoid missed diagnosis of ante-rior cruciate ligament rupture.
Keywords：Tibial fracturesSchatzker type ⅣAnterior cruciate ligamentFractureMissed diagnosisAnterior cruciate ligament reconstructionTomographyspiral computedMagnetic resonance imaging
Publication Date：2023-08-22
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 22-25,39 )