Revisiting the Moore Classification of Knee Fracture–Dislocations Forty-Five Years Later

The understanding of tibial plateau injuries has undergone profound changes over the past four decades. The widespread adoption of computed tomography (CT), magnetic resonance imaging (MRI), and mechanism-based concepts has substantially improved the characterization of fracture morphology and associated soft-tissue injuries. Despite these advances, the Tillman M. Moore classification, published almost half a century ago, remains one of the few classic manuscripts highlighting knee dislocations in certain tibial plateau fracture patterns. When axial imaging was not available in clinical practice, Moore recognized fracture–dislocation as a distinct clinical entity characterized by severe instability, complex fracture morphology, and associated soft-tissue injury. This critical review revisits Moore’s classification forty-five years after its original publication, analyzes its historical significance, critically examines its strengths and limitations, and discusses its remarkable correlation with current management concepts of tibial plateau fractures.