Background. About 1/3 of tibial plateau fractures are associated with proximal fibula fractures, but most proximal fibula fractures are often ignored. The aim of this study was to precisely explain the classification and treatment strategies of six injury types of the fibular column associated with tibial plateau fractures. Methods. Patients with ipsilateral proximal fibula and tibial plateau fractures treated in our hospital were retrospectively reviewed from Aug 2007 to Mar 2020. Two experienced surgeons and two radiologists divided fibular column injury into 6 injury types according to the AO classification and four-column nine-segment classification. The treatment scheme (surgically treated or conservatively treated) was also recorded. Results. In total, 355 proximal fibula fractures were included. Type 2 fibular head fracture was the most common type of injury in 122, and the segregate of superior tibiofibular syndesmosis was the rarest type in 3. In avulsion injury proximal of fibular pattern, the proportion of patients who need surgical intervention is the highest. Conclusions. Six injury types in the four-column nine-segment classification covered all types of bony and soft tissue injuries of the fibular column and concisely explained the injury mechanism. The classification is helpful for the precise judgement and decision-making of the concomitant fibular column injuries in tibial plateau fractures.

中文翻译：

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胫骨平台骨折合并腓骨柱损伤的分类及治疗策略

背景。大约1/3的胫骨平台骨折与腓骨近端骨折有关，但大多数腓骨近端骨折往往被忽视。本研究旨在准确解释胫骨平台骨折六种腓骨损伤类型的分类和治疗策略。方法。回顾性回顾我院2007年8月至2020年3月收治的同侧腓骨近端和胫骨平台骨折患者。2名经验丰富的外科医生和2名放射科医师根据AO分型和四柱九节段将腓骨损伤分为6种损伤类型. 还记录了治疗方案（手术治疗或保守治疗）。结果. 总共包括 355 例腓骨近端骨折。2型腓骨头骨折是122例中最常见的损伤类型，下胫腓联合分离是3例中最罕见的类型。在腓骨近端撕脱伤中，需要手术干预的患者比例最高。结论。四柱九节分类中的六种损伤类型涵盖了腓骨所有类型的骨和软组织损伤，并简明地解释了损伤机制。该分类有助于对胫骨平台骨折合并腓骨柱损伤的准确判断和决策。