Question
A 45 year old man is struck on the outside of the knee by a car bumper. His knee is tense and swollen.
- How are these fractures classified?
- What investigations and early management are needed?
- What are the principles of fixation?
Answer
Schatzker classification
| Type | Description |
|---|---|
| I | Lateral split |
| II | Lateral split depression |
| III | Pure lateral depression |
| IV | Medial plateau |
| V | Bicondylar |
| VI | Metaphyseal diaphyseal dissociation |
Investigation and early care
- CT for fragment mapping
- MRI for meniscal and ligament injury
- Monitor for compartment syndrome, especially in types IV to VI
- Check pulses, as type IV can be a fracture dislocation
- Spanning external fixator for high energy injuries until the soft tissues settle
Fixation principles
- Elevate depressed articular fragments and support them with graft or substitute
- Restore alignment with buttress plating
- Lateral approach with submeniscal arthrotomy and posteromedial approach for medial fragments
- Repair the lateral meniscus
- Early motion with delayed weight bearing
Related pages
Author Contributions
Orthofracs team
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.