Plateau Tibial Fracture Dr. L.A Ledwaba. Epidemiology Common young male elderly females Dr. L.A Ledwaba.

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Presentation transcript:

Plateau Tibial Fracture Dr. L.A Ledwaba

Epidemiology Common young male elderly females Dr. L.A Ledwaba

Location: Lateral Bicondylar Medial Dr. L.A Ledwaba

Mechanism of injury Varus load Vulgus load Axial load Dr. L.A Ledwaba

Associated condition Meniscal tear Tibial fracture Compartment syndrome Crutiate ligament Dr. L.A Ledwaba

Anatomy 1. Osteotogy - Lateral - Medial - Tibial spine 60% weight bearing medial 2. Collateral ligament Dr. L.A Ledwaba

Clinical presentation Dr. L.A Ledwaba Physical examination – inspection: - Rule out an open injury - Palpation - Consider compartment syndrome - Laxity >10 degrees equals instability

CLASSIFICATION Dr. L.A Ledwaba SCHATZKER CLASSIFACTION HOHL AND MOORE

Schatzker classification Lateral split Sphit depression Depression Medial condyl Bicondylar Metaphyseal -diaphysial Type I Type II Type III Type IV Type V Type VI Dr. L.A Ledwaba

Lateral split fracture Dr. L.A Ledwaba

Spilt-depression fracture Dr. L.A Ledwaba

Pure depression fracture Dr. L.A Ledwaba

Medial plateau fracture Dr. L.A Ledwaba

Bicondylar fracture Dr. L.A Ledwaba

Metaphyseal-diaphyseal disassociation Dr. L.A Ledwaba

Hohl and Moore Type I Coronal split Type II Entire condylar fracture Type III Rim Evulsion Type IV Rim compression Type V four part fracture Dr. L.A Ledwaba

X-ray Optional plateau view AP view Lateral view Oblique Caudal tilt Imaging Dr. L.A Ledwaba

CT scan MRI /angiogram Comminution Depression Lipohemarthrosis Meniscal Ligament pathology Vascular injury IMAGING Dr. L.A Ledwaba

Treatment Non-operative - POP - Hinged knee brace - Skin traction Dr. L.A Ledwaba

Non-operative Articular step <3mm Condylar split <3mm Stable knee HINGED BRACE Crutch Pwb 8-10weeks Dr. L.A Ledwaba

Operative treatment 1. Medial plateau 2. Bicondylar Stepoff 3mm 3-5mm widening Dr. L.A Ledwaba

External Fixation Open fracture with contamination Comminution Dr. L.A Ledwaba

Conclusion Dr. L.A Ledwaba Consult Review Records Discuss Consult Review Records Discuss