Tibial plateau fracture

Question 1

x ray given shows a tibial plateau fracture , lateral displacement of tibia on femur , posterior displacement of tibial fragment with intraarticular involvement , question :
what are 3 management priorities in MX of this injury ?

Answer 1

1-analgesia -titrated IV opioids
2- reduction and immolbilisation in above knee back slab
3- CT angiogram for leg for vascular injury

Question 2

List 4 anatomical structures that are likely to be injured which are not seen on plain x ray ?

Answer 2

1-popliteal artery
2-peroneal nerve injury
3-meniscal injury
4-cruciate ligaments injury/ collateral ligament injury

Question 3

List 3 specific complications of tibial plateau fracture ?

Answer 3

1- compartment syndrome
2-foot drop( common peroneal n injury )
3-loss of pulses ( pop art in jury )
4- unstable laxity of the knee joint ( collateral ligament injury )

Question 4

x ray given shows : tibial plateau fracture ( lateral and medical condyles ) , comminuted fracture of fibula , metaphyseal fracture of proximal fibula and lateral displacement of knee joint ,
Name the grade and type of this injury using a recognised classification system ?

Answer 4

Schatzeker 6

Question 5

Schatzker Classification

Answer 5

Type 1 - lateral split fracture
type 2 - lateral split-depressed fracture
type3 -lateral pure depression fracture
type 4- medial plateau fracture
type 5 -bicondylar fractures
type 6-metaphyseal-diaphyseal disassociation