Knee fractures

Question 1

What is a patellar fracture

Answer 1

Fracture of patella from direct trauma or compressive force
or rarer from exessive quadriceps use

often linked with dislocations of patella
and patellar tendon rupture

Question 2

signs and sx of patellar fracture

Answer 2

accident related q
pain at knee
complains of pain on weight bearing, snapping at knee

exam-
bruise/swolled, deformite
tenderness of patella, palpable gap
ROM limited
can straight leg raise
neurocvasc and rule out acetabulum.tibial.femoral fractures

Question 3

ix and mx of patellar fracture s

Answer 3

Xray is best view, and should show

mx- either conservative if non displaced or- knee brace 6w, then crutches
surgery-align articulations with wires, then cast 6w

Question 4

What are tibial plateau fractures

Answer 4

Complex injuries of the knee- crucial because its load bearing
need early detection
can be either high or low impact
often ACL/MCL?LCL associated

seen in RTA, ski, horse riding

use Schatzker classification system

Question 5

Give a rough outline of the schatzker classification

Answer 5

6 types of tibial plateau fractures
1 and 2 are LATERAL
1- fracture without depression - wedge shaped cleavage with low displacement
2-fracture with depression- wedge and compression- depression
3-pure compression-either lateral or central
4- medial tibial plateau fracture with split/depress
5- bicondyle fracture- inverted Y appearance
6- bichondylar fracture with dislocation between metaphysis and diaphysis

Question 6

Signs and sx of tibial plateau fracture injuries

Answer 6

Swelling, inability to weight bear
ROM, pain
mainly mechanism of injury and high index of suspicion
no great examination

Question 7

ix and mx of tibial plateau injury

Answer 7

Xray is main ix

Mx–
surgical always
aim to restore the articular surface and mechanical axis aligmenemtn
open reduce and fix

full extension cast