Plateau Tibial Fracture Dr. L.A Ledwaba. Epidemiology Common young male elderly females Dr. L.A Ledwaba.

Dr. L.A Ledwaba

Plateau Tibial Fracture

Dr. L.A Ledwaba

Epidemiology

Common young male

elderly females

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Location:

Lateral

Bicondylar

Medial

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Mechanism of injury

Varus load

Vulgus load

Axial load

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Associated condition

Meniscal tear

Tibial fracture

Compartment syndrome

Crutiate ligament

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Anatomy

1. Osteotogy - Lateral - Medial - Tibial spine

60% weight bearing medial

• 2. Collateral ligament

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Clinical presentation

Physical examination – inspection: - Rule out an open injury

- Palpation - Consider compartment syndrome

- Laxity >10 degrees equals instability

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CLASSIFICATION

SCHATZKER CLASSIFACTION

HOHL AND MOORE

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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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Lateral split fracture

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Spilt-depression fracture

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Pure depression fracture

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Medial plateau fracture

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Bicondylar fracture

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Metaphyseal-diaphyseal disassociation

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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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X-ray Optional plateau view

AP viewLateral viewOblique

Caudal tilt

Imaging

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CT scan MRI /angiogram

ComminutionDepressionLipohemarthrosis

Meniscal Ligament pathologyVascular injury

IMAGING

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Treatment

Non-operative

- POP

- Hinged knee brace

- Skin traction

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Non-operative

Articular step <3mmCondylar split <3mm

Stable kneeHINGED BRACE

Crutch Pwb 8-10weeks

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Operative treatment

1. Medial plateau

2. Bicondylar

Stepoff 3mm

3-5mm widening

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External Fixation

Open fracture with contamination

Comminution