Tibial plateau fractures typically occur with a bimodal distribution due to high-energy trauma in the young and low-energy trauma in the elderly. Soft tissue injury may be associated with these fractures, with the lateral meniscus most commonly involved, followed by the cruciate ligaments, medial meniscus, and collateral ligaments. These soft tissue injuries are usually not visible on radiographs so an MRI may be considered before fracture fixation.

Meniscal entrapment in the tibial fracture was confirmed at the time of surgery. Excerpt from the operative report:

"The lateral meniscus was completely entrapped within the fracture. This was mobilized and retrieved from the fracture such that it then sat back in the lateral compartment. 3-0 PDS sutures were used in horizontal mattress fashion through the capsule, across the meniscal rim, and back through the capsule to attach the meniscus back to its capsular junction. Despite this, the meniscus did have evidence of nonrepairable traumatic injury at its most anterior aspect."

Case co-author: Karissa Jackson (Loyola University)