title: Anterior tibial plateau fracture: An often missed injury.
abstract: BACKGROUND
  In most classifications of tibial plateau fractures, including one used most widely-Schatzker classification, fractures are described as a combination of medial and lateral condyle, primarily in the sagittal plane. Coronal component of these fractures, affecting the posterior tibial condyle is now well recognized. What is not described is anterior coronal component of the fracture, what we are calling "anterior tibial condyle fracture". These fractures are often missed on routine antero-posterior and lateral knee X-rays due to an overlap between the fracture and the normal bone.
  
  
  METHODS
  Eight cases of anterior tibial condyle fractures with posterior subluxation of the tibia, six of which were missed by the initial surgeon and two referred to us early, are described. Two of the six late cases and both the early ones were operated. Reconstruction of the anterior condyle and posterior cruciate ligament reconstruction was done. Primary outcome measures such as union of the fracture, residual flexion deformity, range of motion and stability were studied at the end of 6 months.
  
  
  RESULTS
  All operated fractures united. There was no posterior sag in any. In those presenting late and were operated, the flexion deformity got corrected in all (average from 15° to 0°) and mean flexion achieved was 100° (range: 80-120°). In those presenting early and were operated, there was no flexion deformity at 6 months and a mean flexion achieved was 115° (range: 100-130°). None of the operated patients had instability.
  
  
  CONCLUSIONS
  This article attempts to highlight that this injury is often missed. They should be suspected, diagnosed early and treated by reconstruction of anterior condyle, posterior cruciate ligament reconstruction.
authors.affiliation: Knee and Shoulder Clinic, New Delhi, India.
authors.forename: Jitendra
authors.initials: J
authors.lastname: Maheshwari
authors.affiliation: Kalyani Knee and Shoulder Clinic, Varanasi, India.
authors.forename: Vinay Kumar
authors.initials: VK
authors.lastname: Pandey
authors.affiliation: Knee and Shoulder Clinic, New Delhi, India.
authors.forename: Vikram Arun
authors.initials: VA
authors.lastname: Mhaskar
keywords: Anterior tibial condyle fracture; Fracture; cruciate ligament; posterior subluxation tibia; tibial fractures; tibial plateau fracture