Predictors of Fracture-Dislocation in Schatzker IV Tibial Plateau Fractures: A Reproducible, Quantitative MRI-Based Injury-Pattern Analysis

NCT07481929 | Completed

• 1 other identifier: JD-HG-2026-011
• Study Type: observational
• Target: 77
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational case-control study aims to evaluate imaging features and associated soft-tissue injury patterns in patients with Schatzker type IV tibial plateau fractures. Adult patients treated surgically at a single tertiary trauma center between January 2019 and December 2025 are included if complete preoperative radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are available. Participants are categorized into fracture-dislocation and non-dislocation groups based on preoperative imaging findings. The study evaluates morphological characteristics of the lateral and posterolateral tibial plateau on CT as well as associated soft-tissue injuries on MRI, including ligamentous, meniscal, and bone contusion patterns. The objective of the study is to characterize imaging features associated with fracture-dislocation and to explore relationships between osseous injury morphology and soft-tissue injury patterns in Schatzker type IV tibial plateau fractures.

Conditions

Tibial Plateau Fracture

Outcome Measures

Primary Outcomes (2)

• Presence of fracture-dislocation in Schatzker type IV tibial plateau fractures

  Fracture-dislocation status determined by preoperative CT, 3D reconstruction, and MRI review

  1year

• Presence of fracture-dislocation in Schatzker type IV tibial plateau fractures

  Fracture-dislocation status determined by preoperative CT, 3D reconstruction, and MRI review

  At baseline (preoperative imaging assessment)

Study Arms (2)

fracture dislocations

Fracture-dislocation (including subluxation) was defined only when there was clear tibiofemoral malalignment or incongruity on preoperative imaging, including lateral tibiofemoral subluxation or dislocation on coronal CT and three-dimensional reconstruction, characterized by complete or partial loss of normal alignment between the lateral tibial plateau and the corresponding femoral condyle. MRI findings, were used as supportive evidence, including lateral translation of the lateral tibial plateau with associated compression, deformation, or abnormal course of the lateral collateral ligament

Behavioral: Is it dislocation?

non fracture dislocations

Fracture displacement alone, without clear tibiofemoral malalignment was not considered sufficient for classification as fracture-dislocation.

Interventions

Is it dislocation? BEHAVIORAL

No study intervention was assigned. This study is a retrospective observational case-control study based on review of existing medical records and preoperative imaging data (radiographs, CT, and MRI) of patients with Schatzker type IV tibial plateau fractures. All patients received standard clinical care determined by the treating surgeons, and no additional procedures or treatments were performed for research purposes.

fracture dislocations

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients with surgically treated Schatzker type IV tibial plateau fractures treated at a single tertiary trauma center between January 2019 and December 2025 were retrospectively reviewed. Eligible patients had complete preoperative radiographs, CT scans, and MRI examinations. Patients were categorized into fracture-dislocation and non-dislocation groups based on preoperative imaging findings. Demographic data, imaging parameters, and associated soft-tissue injuries were analyzed.

You may qualify if:

• Adults aged 18 to 70 years
• Surgically treated Schatzker type IV tibial plateau fracture
• Wahlquist type B or C fracture confirmed on CT
• Availability of complete preoperative radiographs, CT, and MRI

You may not qualify if:

• Fractures other than Schatzker type IV
• Wahlquist type A fractures
• Ipsilateral distal femoral, tibial shaft, or ankle fractures
• Previous surgery of the ipsilateral knee
• Advanced osteoarthritis (Kellgren-Lawrence grade \> 3)
• Pathologic fractures
• Missing key clinical data
• Incomplete or poor-quality imaging precluding accurate measurement

Sponsors & Collaborators

• Second Affiliated Hospital of Soochow University: lead

Study Sites (1)

The medical record system and imaging system of the Second Affiliated Hospital of Soochow University

Schoow, Jiangsu, 252000, China

Location

MeSH Terms

Conditions

Tibial Plateau Fractures

Condition Hierarchy (Ancestors)

Knee Fractures; Fractures, Bone; Wounds and Injuries; Tibial Fractures; Knee Injuries; Leg Injuries

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: OTHER
• Target Duration: 1 Year
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 10, 2026
• First Posted: March 19, 2026
• Study Start: January 1, 2019
• Primary Completion: January 1, 2025
• Study Completion: January 1, 2025
• Last Updated: March 19, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share

Locations

CN (1)