Presentation
Motorcycle accident.
Patient Data
Comminuted fracture of the tibial spine. Joint effusion.
There is a fracture of the tibial plateau in the anterior intercondylar area. The anterior cruciate ligament and the anterior root of the lateral meniscus are attached to a displaced anterolateral fragment. There is further minimally displaced osteochondral fragment of the adjacent inner margin of the medial tibial plateau. From this, a fracture line extends posteriorly into the tibial metaphysis but not to the cortex and also medially and laterally.
The posterior root of the medial meniscus is a avulsed at its tibial attachment. No evidence elsewhere of a meniscal tear.
Incomplete mildly depressed fracture through the cortical bone at the anterior aspect of the medial femoral condyle associated with adjacent bone marrow edema with an overlying articular cartilage injury.
The anterior cruciate ligament is otherwise normal in signal and
morphology. The posterior cruciate ligament and the collateral ligaments are preserved.
Grade 1 chondromalacia of the medial and lateral the sixth of the patella. Moderate joint effusion and extensive subcutaneous edema anteriorly.
Quadriceps tendon, patella, and patellar tendon are unremarkable. Fluid is seen at the insertion of the medial head of gastrocnemius consistent with a partial insertional tear.
The posterior lateral corner structures are unremarkable.
Case Discussion
There is a fracture of the tibial plateau in the anterior intercondylar area and the anterior cruciate ligament and the anterior root of the lateral meniscus are attached to a displaced anterolateral fragment.
Also, a minimally displaced separate osteochondral fragment of the medial tibial plateau with fracture extension into the proximal tibia. Avulsed posterior root of the medial meniscus.
Focal fracture of the anterior aspect of the medial femoral condyle.