Tibial Plateau Fracture Flashcards
How do tibial plateau fractures occur
High energy trauma
Impatient of the femoral condyle
Bone weakness => osteoporosis
what are the clinical features of Tibial plateau fractures
History of trauma
Sudden onset pain
Unable to WB
Swelling of the knee ( due to lips-haemarthrosis )
Tenderness over the lateral/medial aspects of the proximal tibia
What are the differential diagnosis
knee dislocation, other knee fractures (including patella or distal femur), meniscal injuries, ligamentous injuries, patella dislocation, or patella/quadriceps tendon rupture.
What investigations would you carry out
X ray - AP and lateral
CT scans
How are tibial plateau fractures classified
Schatzker Classification
Outline the Schatzker Classification
Type 1 - lateral spilt fracture
Type 2 - lateral split and depressed fracture
Type 3 - Lateral pure depression fracture (rare)
Type 4 - Medial plateau fracture
Type 5 - bicondylar fracture ( rare )
Type 6 - Metaphyseal – diaphyseal disassociation
what is the conservative management of tibial plateau fractures
Hinged knee brace with NWB/PWB for 8-12 weeks
Physio
Analgesia
When is operative management for tibial plateau fractures indicated
Open fractures
Compartment fracture
Complicated fracture eg - more than 10 degrees angular deformity ,any metaphyseal-diaphyseal translation, ligamentous injury requiring repair, or those with associated tibial fractures.
What is the operative treatment
ORIF
Post op - knee brace for 8-12 weeks
What are the complications of tibial plateau fractures.
Post traumatic arthritis