malnited tibial platue....pptxbbbbbbbbge

That patient was suffering from bilateral Friebergs disease , did debridement bilaterally and interposition arthroplasty at out hospitals ( Sayed Galal)

Now patient complaining from continuous pain ( day and night ) on medial aspect of big toe , not related to activity !!

Numbness on medial aspect of big toe and foot , stitching pain at tip of other teo, tightness at lt calf muscle.
O//E there is +ve SLR test , FABER tests bilaterally.

Patient gave me history of old lumbar disc

So patient counselled about her signs , mostly neurological!

X ray dynamic veiw requested
Also MRI LSS requested .That patient was suffering from bilateral Friebergs disease , did debridement bilaterally and interposition arthroplasty at out hospitals ( Sayed Galal)

Now patient complaining from continuous pain ( day and night ) on medial aspect of big toe , not related to activity !!

Numbness on medial aspect of big toe and foot , stitching pain at tip of other teo, tightness at lt calf muscle.
O//E there is +ve SLR test , FABER tests bilaterally.

Patient gave me history of old lumbar disc

So patient counselled about her signs , mostly neurological!

X ray dynamic veiw requested
Also MRI LSS requested .That patient was suffering from bilateral Friebergs disease , did debridement bilaterally and interposition arthroplasty at out hospitals ( Sayed Galal)

Now patient complaining from continuous pain ( day and night ) on medial aspect of big toe , not related to activity !!

Numbness on medial aspect of big toe and foot , stitching pain at tip of other teo, tightness at lt calf muscle.
O//E there is +ve SLR test , FABER tests bilaterally.

Patient gave me history of old lumbar disc

So patient counselled about her signs , mostly neurological!

X ray dynamic veiw requested
Also MRI LSS requested .That patient was suffering from bilateral Friebergs disease , did debridement bilaterally and interposition arthroplasty at out hospitals ( Sayed Galal)

Now patient complaining from continuous pain ( day and night ) on medial aspect of big toe , not related to activity !!

Numbness on medial aspect of big toe and foot , stitching pain at tip of other teo, tightness at lt calf muscle.
O//E there is +ve SLR test , FABER tests bilaterally.

Patient gave me history of old lumbar disc

So patient counselled about her signs , mostly neurological!

X ray dynamic veiw requested
Also MRI LSS requested .That patient was suffering from bilateral Friebergs disease , did debridement bilaterally and interposition arthroplasty at out hospitals ( Sayed Galal)

Now patient complaining from continuous pain ( day and night ) on medial aspect of big toe , not related to activity !!

Numbness on medial aspect of big toe and foot , stitching pain at tip of other teo, tightness at lt calf muscle.
O//E there is +ve SLR test , FABER tests bilaterally.

Patient gave me history of old lumbar disc

So patient counselled about her signs , mostly neurological!

X ray dynamic veiw reque

1. malnited tibial platue b y Dr. Usama Gaber Abdalla Lecturer of Orthopedic Surgery Faculty of Medicine, Al- Azhar University

2. Introduction

3. Tibial plateau fracture is a common type of fracture account for approximately 1.7% of all human fractures and approximately 18.6% of tibial fractures. ( Jansen H, Frey SP, Doht S, Fehske K, Meffert RH. Medium-term results after complex intra-articular fractures of the tibial plateau ).

4. The incidence of malunion after surgical treatment of tibial platue fracture has been reported to be anywhere from 0% to 40% with the latter being in the elderly population over the age of 60 . ( Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates ).

5. Classification of tibial platue malunion :

6. Case presentation

7. Male pt 3 years old . No comorbidity . 2 yrs ago ORIF for medial tibial plateau. presented by knee pain and limbing gait. local examination: tenderness , no signs of infection and limited ROM .

8. Pre x ray:

9. CT

10. OPTIONS ? ? ? ? ?

11. Fixation with ilizarov

12. Clinical assessment

13. Take home message Accurate classification of fracture is essential for good preoperative planning and selection of indicated approach. Intraarticular malunion needed intraarticular osteotomy. Extraarticular malunion needed extraarticular osteotomy.