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

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Presentation on theme: "Plateau Tibial Fracture Dr. L.A Ledwaba. Epidemiology Common young male elderly females Dr. L.A Ledwaba."— Presentation transcript:

1 Plateau Tibial Fracture Dr. L.A Ledwaba

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

3 Location: Lateral Bicondylar Medial Dr. L.A Ledwaba

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

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

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

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

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

9 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

10 Lateral split fracture Dr. L.A Ledwaba

11 Spilt-depression fracture Dr. L.A Ledwaba

12 Pure depression fracture Dr. L.A Ledwaba

13 Medial plateau fracture Dr. L.A Ledwaba

14 Bicondylar fracture Dr. L.A Ledwaba

15 Metaphyseal-diaphyseal disassociation Dr. L.A Ledwaba

16 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

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

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

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

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

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

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

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

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