12/24/2023 0 Comments Tibia fractureMagnetic Resonance images are the diagnostic modality of choice when meniscal, ligamentous and soft tissue injuries are suspected. Computed tomography scans are not always necessary but are sometimes critical for evaluating degree of fracture and determining a treatment plan that would not be possible with plain radiographs. In all injuries to the tibial plateau radiographs (commonly called x-rays) are imperative. Partial or complete ligamentous ruptures occur in 15-45%, meniscal lesions in about 5-37% of all tibial plateau fractures. This explains how 60% of plateau fractures involve the lateral plateau, 15% medial plateau, 25% bicondylar lesions. Also, there is a natural valgus or outward angulation alignment to the limb which coupled with the often valgus or outwardly angulating force on impact will injure the lateral side. The medial plateau is larger and significantly stronger than the lateral plateau. The knee anatomy provides insight into predicting why certain fracture patterns occur more often than others. The tibial condyle is crushed or split by the opposing femoral condyle, which remains intact. Injury can be due to a fall from height in which knee forced into valgus or varus. However, most of these fractures occur from motor vehicle accidents or falls. The classically described situation in which this occurs is from a car striking a pedestrian's fixed knee ("bumper fracture"). Mechanism įractures of the tibial plateau are caused by a varus (inwardly angulating) or valgus (outwardly angulating) force combined with axial loading or weight bearing on knee. These causes constitute the majority of tibial plateau fractures in young individuals. High energy fractures are commonly the result of motor vehicle accidents, falls or sports related injuries. Low energy fractures are commonly seen in older females due to osteoporotic bone changes and are typically depressed fractures. Tibial plateau fractures may be divided into low energy or high energy fractures. A serious complication of tibial plateau fractures is compartment syndrome in which swelling causes compression of the nerves and blood vessels inside the leg and may ultimately lead to necrosis or cell death of the leg tissues. A careful examination of the neurovascular systems is imperative. nerves such as peroneal and tibial) structures, injuries to these may occur upon fracture. Due to the tibial plateau's proximity to important vascular (i.e. Blood in the soft tissues and knee joint ( hemarthrosis) may lead to bruising and a doughy feel of the knee joint. Tibial plateau fractures typically presents with knee effusion, swelling of the knee or fragmentation of the tibia which leads to loss of its normal structural appearance. In the 1920s they were called a "fender fracture" due to their association with people being hit by a motor vehicle while walking. They occur most commonly in middle aged males and older females. Occasionally, if the bones are well aligned and the ligaments of the knee are intact, people may be treated without surgery. In those who are otherwise healthy, treatment is generally by surgery. Pain may be managed with NSAIDs, opioids, and splinting. Some fractures may not be seen on plain X-rays. Diagnosis is typically suspected based on symptoms and confirmed with X-rays and a CT scan. Risk factors include osteoporosis and certain sports such as skiing. The cause is typically trauma such as a fall or motor vehicle collision. Complication may include injury to the artery or nerve, arthritis, and compartment syndrome. Symptoms include pain, swelling, and a decreased ability to move the knee. Patella fracture, fibular fracture, anterior cruciate ligament injury Ī tibial plateau fracture is a break of the upper part of the tibia (shinbone) that involves the knee joint. Suspected based on symptoms, confirmed with X-rays and CT scan Injury to the artery or nerve, compartment syndrome Pain, swelling, decreased ability to move the knee Medical condition Tibial plateau fractureĪ severe tibial plateau fracture with an associated fibular head fracture
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