The Schatzker classification of tibial plateau fractures: a Type IV fracture is characterized by:

• A Pure lateral split fracture of lateral plateau
• B Lateral split-depression fracture
• C Bicondylar fracture with metaphyseal dissociation from diaphysis
• D Medial plateau fracture, frequently associated with ligamentous injury and peroneal nerve injury ✓

Explanation

Schatzker Type IV is a medial tibial plateau fracture. The medial condyle is harder (denser bone) than the lateral, so higher energy is required to fracture it. Medial plateau fractures are associated with high-energy trauma, varus deformity, and commonly with peroneal nerve injury and ligamentous disruption (lateral collateral ligament, posterolateral corner). They carry a worse prognosis than lateral plateau fractures and require ORIF. Schatzker I–III involve the lateral plateau; V–VI involve both condyles.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.