plateau tibial fracture dr. l.a ledwaba. epidemiology common young male elderly females dr. l.a...
TRANSCRIPT
![Page 1: Plateau Tibial Fracture Dr. L.A Ledwaba. Epidemiology Common young male elderly females Dr. L.A Ledwaba](https://reader031.vdocuments.net/reader031/viewer/2022012916/56649ea95503460f94badfbe/html5/thumbnails/1.jpg)
Dr. L.A Ledwaba
Plateau Tibial Fracture
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Dr. L.A Ledwaba
Epidemiology
Common young male
elderly females
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Dr. L.A Ledwaba
Location:
Lateral
Bicondylar
Medial
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Dr. L.A Ledwaba
Mechanism of injury
Varus load
Vulgus load
Axial load
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Dr. L.A Ledwaba
Associated condition
Meniscal tear
Tibial fracture
Compartment syndrome
Crutiate ligament
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Dr. L.A Ledwaba
Anatomy
1. Osteotogy - Lateral - Medial - Tibial spine
60% weight bearing medial
• 2. Collateral ligament
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Dr. L.A Ledwaba
Clinical presentation
Physical examination – inspection: - Rule out an open injury
- Palpation - Consider compartment syndrome
- Laxity >10 degrees equals instability
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Dr. L.A Ledwaba
CLASSIFICATION
SCHATZKER CLASSIFACTION
HOHL AND MOORE
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Dr. L.A Ledwaba
Schatzker classification
Lateral split
Sphit depression
Depression
Medial condyl
Bicondylar
Metaphyseal -diaphysial
Type I
Type II
Type III
Type IV
Type V
Type VI
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Dr. L.A Ledwaba
Lateral split fracture
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Dr. L.A Ledwaba
Spilt-depression fracture
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Dr. L.A Ledwaba
Pure depression fracture
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Dr. L.A Ledwaba
Medial plateau fracture
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Dr. L.A Ledwaba
Bicondylar fracture
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Dr. L.A Ledwaba
Metaphyseal-diaphyseal disassociation
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Dr. L.A Ledwaba
Hohl and Moore
Type I Coronal split
Type II Entire condylar fracture
Type III Rim Evulsion
Type IV Rim compression
Type V four part fracture
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Dr. L.A Ledwaba
X-ray Optional plateau view
AP viewLateral viewOblique
Caudal tilt
Imaging
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Dr. L.A Ledwaba
CT scan MRI /angiogram
ComminutionDepressionLipohemarthrosis
Meniscal Ligament pathologyVascular injury
IMAGING
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Dr. L.A Ledwaba
Treatment
Non-operative
- POP
- Hinged knee brace
- Skin traction
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Dr. L.A Ledwaba
Non-operative
Articular step <3mmCondylar split <3mm
Stable kneeHINGED BRACE
Crutch Pwb 8-10weeks
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Dr. L.A Ledwaba
Operative treatment
1. Medial plateau
2. Bicondylar
Stepoff 3mm
3-5mm widening
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Dr. L.A Ledwaba
External Fixation
Open fracture with contamination
Comminution