Lower Limb: Distal & Proximal Tibia fractures Flashcards
what are proximal tibial fractures also called
Tibial Plateau fractures
describe the different patterns of Plateau tibial fractures
intra-articular fractures with either a split in the bone, a depression of the articular surface or combo of both
what associated complications may come with a high energy tibial plateau fracture
neurovascular injury or compartment syndrome
describe the typical management of proximal tibial fractures
surgery with aim of reduction of articular surface and rigid fixation, with early motion to combat risk of stiffness and post traumatic OA
describe how a lateral plateau fracture may occur
a valgus stress injury to the knee, with failure of MCL and maybe ACL if enough force
describe how a medial plateau fracture may occur
a varus knee injury, with potential for LCL tear
less common
what is usually used for rigid fixation of tibial plateau fractures
plates and screws
what name is given to intra-articular fractures of the distal tibia
‘Pilon’ fracture
describe how extra-articular distal tibia fractures can be treated if in an acceptable position
conservatively or with surgical stabilisation with early motion
describe how in an extra-articular fracture how distal the fracture is determines treatment
if fracture not too distal an IM nail can be used, if too distal for screw plating preferred
what treatment is usually required for ‘Pilon’ fractures
ORIF, to ensure congruent articular surfaces
what mechanism is usually the cause of a ‘Pilon’ fracture
fall from height or rapid deceleration
describe why a ‘Pilon’ fracture is called ‘Pilon’
pilon means pestle in french, in a pilon fracture talus acts as pestle and driuven into the distal tibial articular surface(the mortar)
describe how ‘Pilon’ fractures are treated
surgical emergencies treated with very early fixation if soft tissue envelope satisfactory, OR most cases with temporary external fixation with delayed internal fixation after swelling settles
