Tibial plateau # Flashcards
1
Q
What injuries causes Tibial plateau #?
A
- fall from height
- road traffic accident
- fall in elderly (less common)
2
Q
What are the clinical features of TPF?
A
- Hx of trauma
- sudden onset knee pain
- unable to weigh bear
- knee swelling
- tenderness
- ligament instability
- check neurovascular status
- popliteal vessle dissection or common fibular nerve damage - association of high grade injuries
3
Q
What are the differentials for TPF?
A
- knee dislocation
- knee fractures
- meniscal injuries
- ligamentous injuries
4
Q
What Ix would you order for TPF?
A
- AP and L plain radiograph - lipohaemarthrosis
- CT - needed in all cases
5
Q
What classification is used in TPF?
A
- Schatzker Classification
6
Q
Describe the Schatzker classifictaion
A
Type I: Lateral split fracture
Type II: Lateral split – depressed fracture
Type III: Lateral pure depression fracture (rare)
Type IV: Medial plateau fracture
Type V: Bicondylar fracture (rare)
Type VI: Metaphyseal – diaphyseal disassociation
7
Q
How would you mx TPF?
A
- Conservative
- hinged knee brace
- non weight bearing for 8-12 weeks
- physiotherapy
- analgesia
- Surgical
- ORIF
- hinged knee brace postoperative
- non weight bearing 8-12 weeks
- External fixation
- for severe open # or highly comminuted #
- Arthroplasty
- >65 with osteoporotic bone
- ORIF
8
Q
When is non-operative mx appropriate in TPF?
A
No evidence of
- ligamentous damage
- tibial subluxation
- articular step <2mm
