BACKGROUND Bone bruising of the posterolateral tibial plateau and the lateral femoral condyle sulcus terminalis has a well-established association with anterior cruciate ligament (ACL) tears. Impaction fractures of the femur and tibia may occur in these locations; however, there is a paucity of literature describing these fractures. PURPOSE The primary objective was to quantify the incidence, size, and location of impaction fractures of the posterolateral tibial plateau and lateral femoral condyle in patients with primary ACL tears. The secondary objective was to investigate the association between impaction fractures and concomitant meniscal and ligamentous injuries. STUDY DESIGN Case series; Level of evidence 4. METHODS Patients with available magnetic resonance imaging (MRI) scans who were treated for primary ACL tear by a single surgeon were identified. MRI scans were reviewed with denotation of posterolateral tibial and femoral condylar contusions and displaced impaction fractures. Measurements of the lateral tibial plateau were taken in all patients with displaced lateral tibial plateau fractures and in a subset of control patients without tibial plateau fracture present to characterize the size and location of the bony lesion. Associations of impaction fractures with concomitant meniscal or ligamentous injuries were evaluated through use of chi-square testing. RESULTS There were 825 knees identified with available MRI scans. Lateral tibial plateau bone bruising was present in 634 knees (76.8%), and lateral femoral condyle bone bruising was present in 407 knees (49.3%). Posterolateral tibial plateau impaction fractures were present in 407 knees (49.3%), and lateral femoral condylar impaction fractures were present in 214 knees (25.9%). Patients with posterolateral tibial plateau impaction fractures were older than patients without these fractures (42.6 vs 32.7 years; P < .001), whereas patients with lateral femoral condylar impaction fractures were younger (23.8 vs 32.7 years; P < .001). There were 71 knees (8.6%) with a posterolateral tibial plateau impaction fracture with greater than 10% loss of lateral tibial plateau depth, and this group had an increased incidence of lateral meniscus posterior root tears (22.1% vs 12.0%; P = .02). CONCLUSION Posterolateral tibial plateau impaction fractures occurred with a high incidence (49.3%) in patients with primary ACL tears and demonstrated an increased association with lateral meniscus posterior horn root tears as their size increased. Lateral femoral condylar impaction fractures occurred in 25.9% of patients with primary ACL tears and entailed an increased incidence of lateral meniscal tears and medial meniscal ramp lesions.

中文翻译：

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原发性前十字韧带撕裂中后外侧胫骨平台移位和股外侧Con突骨折的发生率。

背景技术胫骨外侧后外侧平台和股外侧terminal外侧terminal末端的骨挫伤与前十字韧带（ACL）眼泪之间的关联已广为人知。股骨和胫骨的冲击性骨折可能发生在这些部位。但是，很少有文献描述这些骨折。目的主要目的是量化原发性前交叉韧带撕裂患者胫骨后外侧平台和股外侧lateral撞击伤的发生率，大小和位置。次要目的是研究冲击性骨折与伴随的半月板和韧带损伤之间的关系。研究设计案例系列；证据水平4。方法确定可进行磁共振成像（MRI）扫描的患者，该患者由一名外科医生治疗原发性ACL撕裂。回顾了MRI扫描，标出了后外侧胫骨和股骨con突挫伤和移位的冲击性骨折。对所有患有移位的胫骨平台外侧骨折的患者和一部分没有胫骨平台骨折的对照患者进行胫骨平台的测量，以表征骨病变的大小和位置。通过卡方检验评估冲击性骨折与半月板或韧带损伤的相关性。结果进行了MRI扫描，发现825膝。634膝（76.8％）存在胫骨外侧平台骨挫伤，407膝（49.3％）存在股外侧lateral骨瘀伤。胫骨平台外侧后外侧压伤骨折发生在407膝（占49.3％），股骨外侧con外侧压迫骨折发生在214膝（占25.9％）。胫骨平台外侧后外侧骨折的患者比没有骨折的患者年龄更大（42.6 vs 32.7岁； P <.001），而外侧股骨impact突顶部骨折的患者更年轻（23.8 vs 32.7岁； P <.001）。胫骨后外侧平台性骨折有71膝（8.6％），胫骨平台外侧深度损失大于10％，该组外侧半月板后根撕裂的发生率增加（22.1％比12.0％； P =。 02）。结论胫骨平台外侧后外侧骨折发生率高（49。原发性ACL泪液患者的3％）并显示随着其大小的增加，与半月板后角后根部泪液的关联增加。25.9％的原发性ACL撕裂患者发生股外侧con突骨折，并导致外侧半月板撕裂和内侧半月板坡道病变的发生率增加。