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Flashcards in Tibial Plateau Fractures Deck (12):
1

What are associated injuries with tibial plateau fractures?

1) Lateral meniscal tears (peripheral); more common than medial, a/w Schatzker II
2) Medial meniscus tears; most common with Schatzker IV
3) ACL tears; more common in Schatzker V and VI (25%)

2

In an uninjured proximal tibia which statement best describes the shape and position of the medial tibial plateau relative to the lateral tibial plateau?

More concave and more distal

3

What is the classification for tibial plateau fractures?

I- lateral split fx
II- lateral split depression
III- lateral depression
IV- medial condyle fx
V- bicondylar fx
VI- metaphyseal diaphyseal dissociation

4

What are the indications for ORIF of tibial plateau fractures?

1) articular stepoff > 3mm
2) condylar widening > 5mm
3) varus/valgus instability
4) all medial plateau fxs
5) all bicondylar fxs

5

What is the strongest predictor of long term outcomes in tibial plateau fractures?

Restoration of joint stability

6

The posteromedial incision for ORIF of tibial plateau fractures uses what interval?

Between the medial gastroc and semimembranosus

7

When filling a void during ORIF of tibial plateau fracture, what substance has highest compressive strength?

Calcium phosphate

8

What is the post-operative care for ORIF of tibial plateau fractures?

Hinged knee brace, NWB for 8-12 weeks, early RPOM

9

In a Schatzker II tibial plateau fracture, what radiographic measure correlates with a lateral meniscal tear?

Condylar widening of >6mm

10

What variable will most significantly increase the rate of degenerative arthritis in the long-term of ORIF of tibial plateau fractures?

Restoration of mechanical axis

11

What approaches are used for tibial plateau fractures?

1) lateral/anterolateral (1-2cm off tibial crest, extend proximally over Gerdy's tubercle and LFC)
2) posteromedial (1-2cm posterior to posteromedial tibial border)

12

Where should femoral distraction pins be placed in tibial plateau fractures?

1) Shoulder of LFC
2) Well distal to planned plate position

With a lateral distractor, the limb should be placed initially in relative valgus, as distraction creates a varus bending moment when applied