Leg/Knee Case 11 Diagnosis

Tibial Spine Fracture

Tibial spine fractures are best appreciated on plain films.  The lateral views typically best demonstrate the degree of fragment displacement. CT imaging can be obtained if displacement cannot be determined on X-ray alone. 

The Meyer and McKeever classification demonstrates the degree of displacement, which is beyond the scope of ED management but of interest to orthopedics consultants:

• Type I: non-displaced fragment
• Type II: anteriorly displaced fragment with intact posterior hinge
• Type III: completely displaced fragment without posterior hinge
• Type IV: comminuted fracture

MRI grading also exists but is not indicated in the acute ED setting.