# Schatzker — Schatzker classification of tibial plateau fractures

> Classifies tibial plateau fractures by pattern and complexity.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Orthopedic consensus · **Versão:** 1979 · **Ano:** 1979

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: CT, XR
- Fonte primária: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| I | Type I | Lateral tibial plateau fracture without articular depression: a wedge-shaped, pure cleavage (vertical split) of the lateral plateau, typically a low-energy injury in younger patients with good bone quality. | Minimally displaced splits are managed nonoperatively (protected weight-bearing). Operative ORIF is indicated for significant displacement, articular step-off, condylar widening, or instability; lateral depression over ~6 mm or widening over ~5 mm raises concern for associated meniscal/ligament injury that should be addressed. | Lower-energy pattern; soft-tissue injury risk rises with greater depression/widening. Lateral meniscal and ligament tears are associated, particularly as displacement increases. | Wikipedia 'Schatzker classification', Classification subsection (type definition); management and soft-tissue thresholds from StatPearls 'Tibial Plateau Fractures' (NBK470593), Treatment/Complications sections ('articular surface depression of more than 6mm and/or articular widening of more than 5 mm'). | ✓ |
| II | Type II | Lateral tibial plateau fracture combining a cleavage split with depression of the articular surface; the most common type, usually low-energy. | Nonoperative for minimally displaced/depressed fractures; ORIF (often with elevation of the depressed fragment, bone grafting/void filler, and buttress plating) for significant articular step-off, condylar widening, or instability. | Most commonly associated with lateral meniscal tears, especially when articular depression exceeds ~10 mm. | Wikipedia 'Schatzker classification', Classification subsection; management/associations from StatPearls NBK470593, Treatment and Complications sections ('Lateral meniscal tears... most common with Schatzker II... especially with depression >10mm'). | ✓ |
| III | Type III | Focal/pure depression of the lateral (or central) articular surface with no associated split (pure compression); rare; tends to occur in older patients with weaker bone. | Nonoperative if minimally depressed and the joint is stable; ORIF with elevation of the depressed segment and subchondral grafting/void filling when articular depression is significant or the joint is unstable. | Risk of articular incongruity and secondary instability; associated soft-tissue injury is less frequent than in split-depression patterns. | Wikipedia 'Schatzker classification', Classification subsection; management principles from StatPearls NBK470593, Treatment section (nonoperative for minimally displaced split or depression patterns; ORIF for significant step-off). | ✓ |
| IV | Type IV | Medial tibial plateau fracture, with or without depression; may involve the tibial spines. High-energy varus injury often representing a fracture-dislocation. | Generally operative (ORIF); part of the IV/V/VI group for which surgery is recommended. Requires careful neurovascular assessment given the fracture-dislocation mechanism. | Higher rate of neurovascular injury (vascular injury common in IV fracture-dislocations); medial meniscus tears most common in this pattern; ACL injury reported in about a quarter of type IV and VI patterns. | Wikipedia 'Schatzker classification', Classification subsection; risks and operative indication from StatPearls NBK470593, Treatment/Complications ('Schatzker IV, V, and VI injuries' operative; 'ACL injuries... a quarter of Schatzker type IV and VI'; 'Vascular injury... common in Schatzker IV fracture-dislocations'). | ✓ |
| V | Type V | Bicondylar fracture involving split of both the medial and lateral plateaus; high-energy combined varus/valgus mechanism. | Operative (ORIF), frequently with dual plating; staged management with temporary spanning external fixation may be used while soft tissues recover. Part of the IV/V/VI group for which surgery is recommended. | High-energy bicondylar injury carries substantial risk of compartment syndrome and significant soft-tissue compromise. | Wikipedia 'Schatzker classification', Classification subsection; operative indication from StatPearls NBK470593, Treatment section ('Schatzker IV, V, and VI injuries'); compartment syndrome noted as 'a devastating complication'. | ✓ |
| VI | Type VI | Tibial plateau fracture with metaphyseal-diaphyseal dissociation: a transverse subcondylar fracture separating the metaphysis from the diaphysis; high-energy, frequently open. | Operative; commonly staged with temporary spanning external fixation followed by definitive ORIF once soft tissues stabilize. Part of the IV/V/VI group for which surgery is recommended. | High-energy pattern with elevated risk of compartment syndrome, open injury, and neurovascular compromise; ACL injury reported in about a quarter of type IV and VI patterns. | Wikipedia 'Schatzker classification', Classification subsection; operative indication and risks from StatPearls NBK470593, Treatment/Complications ('Schatzker IV, V, and VI injuries' operative; compartment syndrome 'a devastating complication'; ACL injuries in 'a quarter of Schatzker type IV and VI fracture patterns'). | ✓ |

### Citações por categoria
- **I**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection (type definition); management and soft-tissue thresholds from StatPearls 'Tibial Plateau Fractures' (NBK470593), Treatment/Complications sections ('articular surface depression of more than 6mm and/or articular widening of more than 5 mm').
- **II**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection; management/associations from StatPearls NBK470593, Treatment and Complications sections ('Lateral meniscal tears... most common with Schatzker II... especially with depression >10mm').
- **III**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection; management principles from StatPearls NBK470593, Treatment section (nonoperative for minimally displaced split or depression patterns; ORIF for significant step-off).
- **IV**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection; risks and operative indication from StatPearls NBK470593, Treatment/Complications ('Schatzker IV, V, and VI injuries' operative; 'ACL injuries... a quarter of Schatzker type IV and VI'; 'Vascular injury... common in Schatzker IV fracture-dislocations').
- **V**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection; operative indication from StatPearls NBK470593, Treatment section ('Schatzker IV, V, and VI injuries'); compartment syndrome noted as 'a devastating complication'.
- **VI**: Schatzker J, McBroom R, Bruce D. The tibial plateau fracture (Schatzker) (1979) — https://en.wikipedia.org/wiki/Schatzker_classification · Wikipedia 'Schatzker classification', Classification subsection; operative indication and risks from StatPearls NBK470593, Treatment/Complications ('Schatzker IV, V, and VI injuries' operative; compartment syndrome 'a devastating complication'; ACL injuries in 'a quarter of Schatzker type IV and VI fracture patterns').


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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