Best Schatzker Fracture Treatment | Surgery

The bones in the body might be rendered strong by calcium but they still tend to break when they are hit by such a strong external force. When this happens, a bone fracture occurs. A person might have Weber fracture due to the wrong position of the feet upon landing on the ground. There are even different types of Weber ankle fractures that are identified. In kids with growth plate, Salter Harris injury could happen. The doctor will also identify different Salter Harris fracture types.

Another type of fractures that could happen is tibial plateau fracture. This is usually associated with injuries on the ligaments and meniscal parts of the knee. Some doctors would consider this a serious injury, but others would say that this is just a soft tissue injury. Based on the imaging or radiography of most tibial plateau fractures, ligament injury happens 20% to 30% of the time.

Standard tibial fractures are classified under the Schatzker criteria. This is a classification system of tibial fracture wherein the higher the injury is ranked, the more chances that soft tissue injury is involved. The Schatzker classification system is based on the idea that should group together fractures with the same etiological attributes, pathoanatomic factors, and therapeutic features. In this system, the higher the numeric value of a category, the higher the severity and the worse the prognosis for the fractured knee bone. This is if a broken bone is classified as Schatzker fracture, this would already be a lot of help to the orthopedic surgeon when it comes to assessing the injury, managing the pain and other factors, and making prognosis.

In many cases after the Schatzker fracture classification has been made, the rankings might change after the diagnosis and imaging are done. This could be due to a mistake in examining the Schatzker injury without the benefit of imaging from CT scan or MRI scan. These are helpful tools in correctly doing Schatzker classification tibial plateau fractures.

Types of Tibial Fracture (Schatzker Classification)

This classification system of the fractured leg has six types of fractures. The first three Schatzker fractures, types I to III, are usually caused by injury that is of low impact due to a low injury performance. The second batch of fracture of tibia, types IV to VI, is caused by high level injury. Depending on how strong the force that hit the broken tibia bones of the patient, some level of fragmentation and displacement are bound to happen. A good fracture diagnosis would help discover the right type of fracture in a patient. It should be noted that some fracture complications would happen. In some cases, fracture surgery might be necessary.

Type I

The Schatzker bone fracture occurs on the cleavage part of lateral tibial plateau. It usually has 4mm of depression or displacement in the fracture. If this is compared to type II, they would appear almost the same. The depth of the depressed tibial plateau fracture cannot be measured though with the help of ordinary radiographs due to how subtle they appear. The break in the bone happens when the lateral femoral condyle is driven to the surface of the tibial plateau. Among all the types of tibial plateau fracture, this accounts for six percent of the case. This usually happens to younger patients with proper bone mineralization. When it comes to fracture healing time, this type would heal the fastest among the six types. Anyone would like to hasten recovery time so as to return to normal activities.

An impact on the side of the knee would also result to having distraction injury. The fracture of knee usually happens with a vague force and axial loading. On how to treat Schatzker type I fracture, it should be able to align, stabilize, and relieve the pain in the joint. This ought to likewise help limit the confusions of posttraumatic osteoarthritis.. The patient can choose between open reduction and internal fixation (ORIF) with or without arthroscopy. The operation would also make use of two screws. This is only one way on how to heal a tibial fracture. Taking medicines would be necessary in some cases, especially of the pain escalates in the cold.

Type II

This type of fracture happens to the cleavage of the fracture along with compression on the lateral tibial plateau fracture. It is also characterized by its depression in the fractured area. Like in the case of type I, the depression cannot be easily detected and studied with plain radiograph and it would look like type I too. When the fracture is more than 4mm, it is already considered as a depression. This type II fracture accounts for 25% of all the fractures on the tibial plateau. The usual victims of this fracture are those in their 40s and older due to the occurrence of the disease called osteopenia. The injury usually happens when there is also a vague force that hits the knee. Distraction injury is still a common associated injury that happens on the meniscal. This type of fracture is treated with an open surgery for the unstable fracture. This could be a way on how to treat Schatzker fracture quick.

Type III

There are two types of this fracture – type IIIA or a fracture with lateral depression and type IIIB or a fracture with central depression. This fracture usually affects the stability of axial, which usually happens with type IIIB fractures. Type IIIA can be treated even without surgery if there is only a small articular depression and the joint remains fixed in place and untouched. On the other hand, type IIIB might receive more serious injuries that have to be elevated with the use of a submetaphyseal cortical window. Type III fracture treatment may be done with arthroscopic reduction.

Arthroscopic assistance is really necessary with types I and III while types II, IV, V, VI do not really use this type of assistance.

Type IV

This refers to a medial tibial fracture with depression. The injury usually happens with axial loading and varus force. When the knee suffers from posteromedial coronal split, this could be due to a hyperflexed knee and axial loading. Type IV accounts for ten percent of all the fractures to the knee and has the worst prognosis of all the tibial plateau fractures. Schatzker fracture in children, who are balls of energy, would likely happen due to their high energy. The dislocation in this fracture might also damage the popliteal and peroneal nerves. Older patients would likely have the fracture due to a low energy blow.

Type V

This has the medial and lateral tibial plateau broken. The most visible characteristic of this fracture is its Y appearance. The lateral plateau would have an articular depression that cannot be addressed by first aid treatment. Unlike the type VI fracture, Schatzker V fracture has metaphyseal-diaphyseal continuity. This only accounts for three percent of all the fractures in the tibia. This usually happens due to a high energy mechanism, which is possible in a motor vehicle collision. Other associated injuries would include avulsion injury and peripheral meniscal detachment.

In type V, condylar fracture happens which cause your injury to be unstable. Bicondylar fractures have the cruciate ligaments bear the pressure of maintaining joint stability. If there is another fracture on the interconylar eminence, this is already labeled as a four-part fracture that results to the instability of the knee.

In this Schatzker tibial fracture, splinting or putting a fracture cast can be an option. Temporary fixation can also help hasten treatment to start with rehabilitation of the injured part.

Type VI

This Schatzker 6 fracture is characterized by a transverse subcondylar fracture with the metaphysic disassociated from the diaphysis. This accounts for 20% of all the tibial fractures. The mechanism of the injury is due to a high level of energy that hits the knee. Schatzker VI tibial plateau fracture is also another complicated fracture, just like type V. Thus, the patient cannot expect quick rehab afterwards. Those exercises to restore the body to the way it was have to wait and to help shorten the Schatzker fracture healing time. One-third of these types of Schatzker VI fracture is open and is usually associated with extensive soft tissue injury. Moreover, the patient is exposed to experiencing compartment syndrome.