Knee Dislocations and Fractures Flashcards
Knee
Articulation between distal femur and proximal tibia
Distal femoral fractures aetiology
Osteoporotic bone
Fall onto flexed knee
Distal femoral fractures types
Intracapsular
- Intercondylar
Extracapsular
-Supracondylar
Adopts a flexed position due to the pull of the gastrocnemius
distal femoral fractures. treatment
plate aims screws
position is difficult to maintain in a cast
True knee dislocation
Surgical emergency
High incidence of vascular injury
- assessed by doppler, duplex scan, angiogram
Nerve injury
Compartment syndrome
When does a true knee dislocation reduce ?
Spontaneously when knee is straightened
During manipulation
True knee dislocation risk factors
Ligamentous laxity
Valgus alignment of the knees
Rotational amalaignment
Shallow trochlear groove
True knee dislocation consequences
Tenderness over medial retinaculum
- where medial patellofemoral ligament is torn
Haemarthrosis
- impaction of medial patellar facet on outer aspect off lateral femoral condyle
Treatment to prevent further dislocation (after true knee dislocation)
Temporary splintage followed by physiotherapy
- key to strengthen vests medals
many adolescents stabilise with time
Surgical stabilisation is rarely required
Tibial plateau fractures
Intra-articular fractures with either
-a split in the bone
- depression of the articular surface
(or both)
Tibial plateau fracture classification
Schatzker System
Type I: Split Type II: Split-depression Type III: Central depression Type IV: Split fracture, medial plateau Type V: Bicondylar fracture Type VI: Dissociation of metaphysic and diaphysis
Tibial Plateau fracture aetiology
High energy- younger patients
Low energy- older patients
Tibial Plateau fracture treatment
Reduction of articular surface
Rigid fixation with early mobilisation
Medial tibial plateau fracture aetiology
Caused by virus injury
Depressed tibial plateau fracture treatment
Bone grafting used to fill void in bone
- usually morsellised packed cancellous autograft
