A 23-year-old athlete sustains a Schatzker type IV tibial plateau fracture (medial condyle fracture) after a valgus knee injury. What associated injury MUST be actively excluded?
- A Peroneal nerve injury and popliteal artery injury ✓
- B Posterior cruciate ligament tear
- C Medial collateral ligament avulsion
- D Anterior cruciate ligament tear with lateral meniscal bucket-handle tear
Explanation
Schatzker type IV is a medial tibial plateau fracture caused by varus force or axial loading and carries the highest risk of neurovascular injury among all tibial plateau fractures. The popliteal artery (tethered proximally at the hiatus and distally at the soleal arch) and the common peroneal nerve (coursing around the fibular neck) are at risk of stretch injury or entrapment. Vascular injury occurs in up to 10–15% of high-energy medial condyle fractures. An urgent vascular assessment and ankle-brachial index are mandatory. ACL/MCL tears are more typical of Schatzker I–III lateral plateau injuries.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.