S4 (knee)

Question 1

Fémoral shaft fractures

Answer 1

Usually high velocity trauma (car crash, fall from height, consider child abuse)
In elderly with osteoporotic bones/pts with bone métastases, lésions can just be in a normal fall

Prox fragment usually abducted (glut med and min), flexed (iliopsoas).
Dist fragment adducted (add mag, gracilis),extended (gastrocnemius)

Tense swollen thigh, average blood loss 1000-1500ml (closed fem fracture, could be double in open), may get hypovolaemic shock

Surgical fixation to treat

Question 2

Distal femoral fractures

Answer 2

Younger pts usually high energy sport with sig displacement of the fracture fragments
In elderly usually in association with osteoporotic bone and fall from standing

Pop art may be damaged if sig displacement and neurovasculatur

Question 3

Tibial plateau fractures

Answer 3

Usually high energy injuries
Usually due to top to bottom (axial) loading with Varus or valgus angulation (an abnormal medial or lateral flexion load) on the knee

Affect the articulating surface of the tibia inside joint
Can be uni or bicondylar (lat is most common)

Articulat cart always damaged
Most patients get post traumatic osteoarthritis

Can be associated with me is also tears and acl injuries