Tibial plateau fractures are complex intra-articular injuries where careful CT assessment dictates whether the knee joint survives. In this Orthovellum masterclass, we break down the Schatzker classification, the three-column conceptand the staged management of these high-energy fractures. ⏱ Chapters 0:00 Intro 0:28 Anatomy 0:53 Essentials 1:17 Classification 1:59 Management Algo 2:26 Assessment 2:49 Numbers 3:12 Algorithm 3:43 Clinical reasoning — Classify 4:27 Clinical reasoning — Compartment This video provides a comprehensive guide to understanding and managing tibial plateau fractures. We cover the essential anatomy, biomechanicsand injury mechanisms before diving deep into the Schatzker and Luo three-column classifications. You will learn the critical importance of soft tissue evaluation, the 'wrinkle sign', and how to plan your surgical approaches, articular reductionand raft screw fixation to prevent post-traumatic osteoarthritis. 🦴 IN THIS VIDEO YOU'LL LEARN • How to accurately classify tibial plateau fractures using the Schatzker and Luo three-column systems • Why the lateral plateau is more susceptible to depression fractures than the medial side • How to interpret CT scans to identify posterior column involvement and true articular depression • The indications and threshold for non-operative versus operative management • The staged management paradigm for high-energy bicondylar fractures using spanning external fixation • How to safely time definitive open reduction and internal fixation based on the wrinkle sign and soft tissue condition • The surgical principles of elevating depressed articular surfaces, bone graftingand applying raft screws • How to identify and manage associated injuries including meniscal tears, ligament disruptionsand neurovascular compromise ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Always treat medial plateau fractures (Schatzker IV) as high-energy injuries until proven otherwise. ✔️ A CT scan is essential for surgical planning; plain radiographs miss posterior column involvement in up to 30% of cases. ✔️ Never operate through hostile, swollenor blistered skin—use a spanning external fixator and wait for the positive wrinkle sign. ✔️ An articular step-off of greater than 2mm significantly increases the risk of post-traumatic osteoarthritis. ✔️ Up to 90% of high-energy tibial plateau fractures involve a meniscal injury which must be addressed during fixation. ✔️ Always exclude compartment syndrome and popliteal artery injury, particularly in fracture-dislocation patterns (Moore classification). 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical studentsand junior doctors seeking a comprehensive understanding of lower limb trauma. Curious patients looking for detailed, clinically accurate information about their knee injury and surgical treatment will also find it highly valuable. 📚 RELATED TOPICS: Luo Three-Column Concept of the Tibial Plateau · Schatzker Classification memory aids and mnemonics · Soft tissue management and the wrinkle sign in orthopaedic trauma · Popliteal artery injuries and knee fracture-dislocations · Surgical approaches for posterior column tibial plateau fractures · Compartment syndrome of the leg clinical assessment 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #tibialplateau #trauma #orthopaedicsurgery #kneefracture #schatzker #orthoteaching #fracturefixation #kneetrauma #bonetrauma #medicaleducation #orthopedicsurgery