Medial plateau split-depression fracture

Partial articular fractures with a split-depression are classified by the AO/OTA as 41B3 fractures, and medial plateau split depressions are classified by the AO/OTA as 41B3.2 fractures. Preoperative imaging studies are crucial to determine the extent and location of the impacted articular surface.

These fractures are rare and often occur as a result of high-energy force. They may be associated with meniscal tears, ligament rupture, neurovascular lesions, and compartment syndrome.

An oblique split depression, involving the tibial spines and one of the surfaces, is classified as a 41B3.3 fracture.

Treatment of this fracture has many pitfalls. Besides the unstable large medial fragment, a significant posterolateral articular surface depression is quite common. The anterior cruciate ligament and lateral meniscus are frequently injured.