Plateau Tibial Fracture presentation (1).pptx

Tibial plateau fracture presentation

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 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