Proximal Tibia (plateau) fractures

Question 1

Likely cause if young?

Answer 1

High energy injury

Question 2

Likely cause if osteoporotic?

Answer 2

Low energy injury

Question 3

What is proximal tibia fracture?

Answer 3

Split in bone and/or depression of articular surface

Question 4

If there is a valgus injury?

Answer 4

-Lateral plateau fracture-Failure of MCL -Failure of ACL (?)

Question 5

If there is a direct blow?

Answer 5

-Proximal tibia and fibula fracture -Injury to common peroneal nerve (foot drop)

Question 6

Varus injury?

Answer 6

-Medial plateau fracture -Potential LCL rupture -Stretch injury to common peroneal nerve

Question 7

Investigation of proximal tibia fracture?

Answer 7

CT scan: plan surgical fixation

Question 8

Treatment of proximal tibial fracture?

Answer 8

-Reduction of articular surface + rigid fixation (plates and screws)-Also usually need some grafting -Early motion

Question 9

Treatment of high energy fracture?

Answer 9

-may require external fixator spanning joint first (swelling resolve)-Then open reduction & internal fixation