Complete articular fracture with fragmentary lateral plateau

Multifragmentary articular fractures characterized by the involvement of both the medial and lateral condyles are classified by the AO/OTA as 41C3 fractures. A complete articular fracture with fragmentary lateral plateau is classified as 41C3.1. The metaphyseal part of the fracture may be multifragmentary as well.

They usually result from high-energy injuries. In addition to the bicondylar fragmentation there is metaphyseal comminution with loss of continuity between the proximal epiphysis and the diaphysis.

A major concern in managing these severe injuries is the invariably present severe soft-tissue envelope injury. Treatment of these fractures is difficult and requires careful judgment and technical expertise.

This image shows articular comminution and depression of the lateral tibial plateau. There is no transarticular medial plateau fracture.

Coronal image showing simple medial condyle fracture and markedly depressed comminuted lateral plateau fracture.