5. Knees & Tib/Fib Flashcards by J Y

the lower leg is what structure and what does this mean for fractures

ring structure

fracture of one bone might also include a fracture of the other bone or include a disruption of a joint

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what are toddler’s fractures in terms of fracture line and where it is in the bone

non displaced spiral or oblique fracture through the distal 3rd of the tibia

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what are tibial stress fractures caused by in children

chronic mechanism stress/repetitive force

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what do tibial stress fractures look like

increased density in area and can have callous formation if its a repairing stress fracture

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what type of fractures are tibial stress fractures

insufficiency fractures

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what are tibial stress fractures caused by in older patients

abnormal bone with normal forces

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what is knee joint filled with

synovial fluid

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what holds the patella in place

tendons

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if there is a # in the knee area what can happen in terms of the joint space

bleed into knee joint and fat from marrow of bone can get into joint leading to effusion or lipohaemarthrosis

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what does a normal suprapatellar bursae look like

nice and flat, not thickened

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what does an abnormal suprapatellar bursae look like

thickened

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what are the 6 types of patella fractures

transverse
vertical
marginal
comminuted
osteochondral
sleeve

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sleeve patella fractures occur in which type of patient and what happens what happens if its not treated

only in children

cartilage pulls off the patella almost like avulsion

if not treated bone can keep growing and form an additional patella

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what needs to be considered for patella fractures

dont bend knee as it may displace it

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what leads to patella alta

avulsion # of inferior patella

fragment of bone pulled off and stays behind onto patella ligament

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what cant the patient do with patella alta

cant extend knee

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what happens to the patella in patella alta in terms of location

gets pulled up

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what is bipartite patella

Normal variant occurring in supralateral aspect of patella but looks like a # as patella ossification centre hasn’t ossified properly

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what is the tibial plateau 5mm rule

Draw line from lat condyle femur straight down

If small section sticking out is >5mm know we need to look for tib plateau #

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what is a schatzke 1 tibial plateau fracture

lateral tibial plateau fracture without depression

what is a schatzke 2 tibial plateau fracture

lateral tibial plateau fracture with depression

what is a schatzke 3 tibial plateau fracture

compression fracture at the tibial plateau - lateral depression into tibial metaphysis

what is a schatzke 4 tibial plateau fracture

medial tibial plateau fracture

what is a schatzke 5 tibial plateau fracture

bicondylar tibial plateau fracture

what is a schatzke 6 tibial plateau fracture

tibial plateau fracture with diaphyseal discontinuity metaphyseal fracture that separates from the diaphysis

what is schatzke 1 tibial plateau fracture caused by

valgus stress bumper injury - Something pushes joint inwards and femoral and tibial condyles press together

which is the most common type of tibial plateau fracture caused by

type 2

what patients are likely to get type 1 tibial plateau fracture

younger patients with stronger bones which are resistant to depression

what patients are likely to get type 2 tibial plateau fracture

older patient with osteoporosis that does not resist depression

what are the 2 types of fracture types that could be involved in a type 4 tibial plateau fracture

split fracture or split depression

what part of the tibia and what nerve can also be involved in the type 4 tibial plateau fracture

tibial spines peroneal nerve

what happens to the metaphysis and diaphysis in the type 5 tibial plateau fracture

metaphysis still in continuity with diaphysis

what causes type 5 tibial plateau fracture

pure axial stress with severe trauma

what articular surfaces are involved in the type 6 tibial plateau fracture

medial, lateral or both

what is osteochondritis dissecans and what causes it

reduced blood flow to the area due to repetitive stress

what happens to the area involved in osteochondritis dissecans

area becomes avascular, necrotic and brittle and can fragment into the joint

what surfaces do osteochondritis dissecans occur on

convex surfaces

what is osgood schlatter

osteochondritis of tibial tubercle

what causes osgood schlatter

repetitive extensor mechanism stress causing microtears, fractures and inflammation

what could happen in osgood schlatter if its not treated

self limiting so could develop bump under skin

what do neoplasms - osteosarcomas look like in images

onion skinning periosteal reaction and codmans triangle show malignancy

how are neoplasms - osteosarcomas treated or managed

Limb salvage therapy and surgery to remove bone and muscle flaps surgically brought across to allow patient movement, whole bone removed

what are pathological fractures

tumor erodes bone and weakens bone increasing fracture risk

what are exostoses

benign growths of bone

which way do exostoses grow

away from joint

what is hereditary/multiple exostoses

diaphyseal aclasis

what images are taken for knee OA

weight bearing sees joint space when gravity is acting on knee

what is OA characterised by - 4 things

Characterised by narrowed joint space, sclerotic margin, subchondral cysts and osteophytes