scholarly journals Open posterior dislocation of the knee with rupture of the patellar tendon and a tibial plateau fracture

2010 ◽  
Vol 2 (1) ◽  
pp. 7 ◽  
Author(s):  
Mohammed Fahd Amar ◽  
Badr Chbani ◽  
Oussama Ammoumri ◽  
Amine Marzouki ◽  
Fawzi Boutayeb
Keyword(s):  
Patellar Tendon ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Tissue Injury ◽  
Full Range ◽  
Soft Tissue Injury ◽  
Knee Dislocation ◽  
High Energy ◽  
Plateau Fracture ◽  
Posterior Knee

Knee dislocations are rare injuries. They represent a severe soft tissue injury following high-energy blunt trauma. We report a case of open posterior knee dislocation with rupture of the patellar tendon and a fracture of the tibial plateau. The treatment was surgical and consisted of reduction of the knee dislocation, fixation of the tibial plateau fracture by lag screws, and transosseous sutures for the patellar tendon protected by a patellotibial cerclage. The result was successful with full range of motion.

Tibial plateau fracture: anatomy, diagnosis and management

2020 ◽  
Vol 81 (10) ◽  
pp. 1-9
Author(s):  
Branavan Rudran ◽  
Christopher Little ◽  
Anatole Wiik ◽  
Kartik Logishetty
Keyword(s):  
Surgical Management ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Lateral Condyle ◽  
Mechanism Of Injury ◽  
Schatzker Classification ◽  
Plateau Fracture

Tibial plateau fractures are peri-articular knee fractures of the proximal tibia. The presentation is dependent on the mechanism of injury. The tibial plateau is the bony platform of the distal half of the knee joint, and is made up of a medial and lateral condyle separated by the intercondylar eminence. The presentation of tibial plateau fractures can vary greatly as a result of the bimodal mechanism of injury and patient characteristics. The patient should be assessed for life- and limb-threatening injuries in accordance with British Orthopaedic Association Standards of Trauma guidelines. Imaging is undertaken to understand configuration of the fracture, which is classified by the Schatzker classification. Definitive management of the fracture depends on the severity, ranging from conservative to surgical management. Surgery is required for more severe tibial plateau fractures to restore articular congruity, mechanical alignment, ligamentous stability and to permit early mobilisation. Medium-term functional outcome after tibial plateau fractures is generally excellent when anatomy and stability is restored. At least half of patients return to their original level of physical activity. Surgical management of tibial plateau fractures is not without complication. Risk factors include postoperative arthritis, bicondylar and comminuted fractures, meniscal removal, instability, malalignment and articular incongruity. Tibial plateau fractures account for 1% of all fractures, and typically occur either as a fragility fracture or secondary to a high-energy impact. These latter injuries are associated with extensive soft tissue injury, life- and limb-threatening complications and long-term sequelae. While outcomes are generally good, severe injuries are at higher risk of infection and post-traumatic arthritis requiring knee arthroplasty. This article considers the anatomy, diagnosis and evidence-based management strategies for tibial plateau fracture.

scholarly journals A study of minimally invasive percutaneous plate osteosynthesis for tibial plateau fractures

2017 ◽  
Vol 4 (1) ◽  
pp. 92
Author(s):  
Ujwal S. Ramteke ◽  
Vidyadhar Telang ◽  
Nadir Shah ◽  
Ayush Singh ◽  
Hitesh Mangukiya ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
Full Range ◽  
Tibial Plateau Fractures ◽  
Type I ◽  
X Rays ◽  
Age Group ◽  
Schatzker Type ◽  
Plateau Fracture

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of proximal tibia involve a major weight-bearing joint and are serious injuries, which, if not treated well, result in functional impairment. To preserve normal knee function one must strive to maintain joint congruity, preserve the normal mechanical axis, ensure joint stability and restore a full range of motion. This is a formidable task to accomplish, especially in the face of associated medical conditions of the patients</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">In our study, 30 cases were selected. Selection of cases were done on the basis of X-rays. Schatzker type I, II, III, IV, V &amp; VI included in study. Criteria for acceptable reduction 1) &lt;5 mm of articular step; 2) &lt;5 mm of articular depression. Each case is referred to one set of tibial plateau fracture, showing distribution of tibia plateau fractures that we treated with MIPPO. Clinical follow-up examination was performed at 4, 6, 10, 12 weeks and 3, 6 months. Clinico-radiological assessment was done at 3 month and grading was done. Patients were evaluated according to grading minimum 3 months after injury</span>.</p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">Our study of 30 tibial plateau fractures confirms that the MIPPO technique is an excellent treatment modality in case of tibial plateau fractures. We observed these fractures mainly in age group of 30-40 years, which were involved in road traffic accident. Tibial plateau fractures seen in elder age group were mainly due to abnormal loading patterns on the leg. We have found oblique views very much informative especially for posterolateral or posteromedial displacement, articular depression which helps to plan the position and direction of screws to be used for fixation</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">In view of the excellent results obtained with this technique, we advocate MIPPO over conventional open reduction and internal fixation technique for tibial plateau fracture fixation</span><span lang="EN-IN">.</span></p>

scholarly journals REHABILITATION OF A 60-YEAR-OLD WOMAN’S TIBIAL PLATEAU FRACTURE

2021 ◽  
Vol 10 (4) ◽  
pp. 3229-3232
Author(s):  
Mithushi Deshmukh
Keyword(s):  
Knee Joint ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
Full Range ◽  
The Body ◽  
Normal Functioning ◽  
Tibial Condyle ◽  
Plateau Fracture ◽  
Condyle Fracture

Tibial plateau fracture is one of the commonest fractures which leads to the break in the continuity of the upper part of the tibia (shinbone) that involves the knee joint. It involves either lateral tibial condyle or medial tibial condyle or both. This fracture interferes with the normal functioning of the body in day-to-day life. Therefore, physiotherapy rehabilitation after surgery is essential to get back to normal functioning. A 60-year-old female who slipped from a two-wheeler started experiencing severe pain & swelling around the knee joint. Her relatives brought her to Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, Maharashtra. X-ray was done and she was diagnosed with lateral tibial condyle fracture (tibial plateau fracture) and then underwent open reduction internal fixation with plate osteosynthesis. Later, she was referred for physiotherapy rehabilitation, which aimed to restore mobility, regain full range of motion, develop muscle strength and build up to weight-bearing. The tibial plateau fracture is a form of fracture with a low occurrence and is a complicated fracture to treat.The above case study concludes that a traditional surgical procedure combined with timely planned physiotherapy rehabilitation contributed to progressive improvement in functional goals, which is an important factor in achieving a good recovery in such post-operative cases.

scholarly journals Posterolateral Corner Injury Associated with a Schatzker Type 2 Tibial Plateau Fracture

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Boris A. Zelle ◽  
James R. Heaberlin ◽  
Matthew C. Murray
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Treatment Options ◽  
Full Range ◽  
Posterolateral Corner ◽  
Physical Exam ◽  
Initial Assessment ◽  
Schatzker Type ◽  
Plateau Fracture

Isolated posterolateral corner (PLC) injuries are rarely seen with tibial plateau fractures and can be missed during the initial assessment. The objective of this paper is to present a case of a Schatzker type 2 tibial plateau fracture with associated isolated PLC injury and give a discussion on physical exam, diagnostic studies, and treatment options. A twenty-five-year-old female sustained a concomitant Schatzker type 2 fracture and PLC injury. Magnetic Resonance Imaging showed an isolated PLC disruption. Open reduction-internal fixation was performed with subsequent PLC repair. At sixteen months postoperatively, the patient had full range of motion and strength of her knee and no signs of laxity. This case emphasizes the importance of physical exam and appropriate imaging modalities in order to diagnose and treat this significant injury in a prompt fashion. In this case, surgical fracture fixation and subsequent repair of the PLC provided a good clinical outcome.

scholarly journals Reliability and repeatability of tibial plateau fracture assessment with an injury mechanism-based concept

2019 ◽  
Vol 8 (8) ◽  
pp. 357-366 ◽  
Author(s):  
B-B. Zhang ◽  
H. Sun ◽  
Y. Zhan ◽  
Q-F. He ◽  
Y. Zhu ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Fracture Morphology ◽  
High Energy ◽  
Initial Position ◽  
Injury Mechanism ◽  
Schatzker Classification ◽  
Plateau Fracture ◽  
Fracture Assessment ◽  
The Right

Objectives CT-based three-column classification (TCC) has been widely used in the treatment of tibial plateau fractures (TPFs). In its updated version (updated three-column concept, uTCC), a fracture morphology-based injury mechanism was proposed for effective treatment guidance. In this study, the injury mechanism of TPFs is further explained, and its inter- and intraobserver reliability is evaluated to perfect the uTCC. Methods The radiological images of 90 consecutive TPF patients were collected. A total of 47 men (52.2%) and 43 women (47.8%) with a mean age of 49.8 years (sd 12.4; 17 to 77) were enrolled in our study. Among them, 57 fractures were on the left side (63.3%) and 33 were on the right side (36.7%); no bilateral fracture existed. Four observers were chosen to classify or estimate independently these randomized cases according to the Schatzker classification, TCC, and injury mechanism. With two rounds of evaluation, the kappa values were calculated to estimate the inter- and intrareliability. Results The overall inter- and intraobserver agreements of the injury mechanism were substantial (κinter = 0.699, κintra = 0.749, respectively). The initial position and the force direction, which are two components of the injury mechanism, had substantial agreement for both inter-reliability or intrareliability. The inter- and intraobserver agreements were lower in high-energy fractures (Schatzker types IV to VI; κinter = 0.605, κintra = 0.721) compared with low-energy fractures (Schatzker types I to III; κinter = 0.81, κintra = 0.832). The inter- and intraobserver agreements were relatively higher in one-column fractures (κinter = 0.759, κintra = 0.801) compared with two-column and three-column fractures. Conclusion The complete theory of injury mechanism of TPFs was first put forward to make the TCC consummate. It demonstrates substantial inter- and intraobserver agreement generally. Furthermore, the injury mechanism can be promoted clinically. Cite this article: B-B. Zhang, H. Sun, Y. Zhan, Q-F. He, Y. Zhu, Y-K. Wang, C-F. Luo. Reliability and repeatability of tibial plateau fracture assessment with an injury mechanism-based concept. Bone Joint Res 2019;8:357–366. DOI: 10.1302/2046-3758.88.BJR-2018-0331.R1.

scholarly journals Tibial Plateau Fracture Following Low Energy Fall in the Rocky Mountains

2019 ◽  
Vol 12 (3) ◽  
pp. 91-93
Author(s):  
Alexandra V. Arvanitakis ◽  
Kerry C. Mian ◽  
Raymond Kreienkamp ◽  
Charles E. Rhoades
Keyword(s):  
Rocky Mountains ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Weight Bearing ◽  
High Energy ◽  
Classification Systems ◽  
Tibial Plateau Fractures ◽  
Mechanism Of Injury ◽  
Direct Trauma ◽  
Plateau Fracture

Tibial plateau fractures are debilitating injuries. They can occurin younger individuals who sustain a high energy trauma or, withincreasing age, lesser degrees of trauma and underlying bone pathology such as osteoporosis, metabolic bone disease, and malignancy.1Outside these cases, tibial plateau fractures are relatively uncommon.However, these fractures can occur in healthy patients who have sustained direct trauma to the knee.Fractures of the tibial plateau often are classified according to theSchatzker or AO classification systems.2,3 These systems evaluate theinvolvement of both the medial and lateral plateaus, degree of comminution, extension into the joint, and displacement (both articularsurfaces and the relationship of the diaphysis to the metaphysis).Most tibial plateau fractures occur in the lateral aspect of the tibialplateau.1 The increased frequency of lateral fractures is due to themedial tibial plateau being able to resist higher weight-bearing loaddue to the presence of more cancellous bone. More importantly, thelateral plateau has more articular surface exposed during extensioncompared to the medial plateau, which increases likelihood of injury.4The standard of care for most displaced tibial plateau fracturesis surgical management with open reduction and internal fixation(ORIF).5 Conservative management, such as leg bracing, is an optionfor fractures that are nondisplaced or in patients too fragile for surgical intervention. In the senior population, a total knee arthroplasty(TKA) is a less common option. Tibial plateau fractures, particularlymedial tibial plateau fractures, caused by direct trauma in the elderly,non-osteoporotic population are uncommon.We present the case of an active male without overt risk for severefracture (10-year fracture risk of 10% via FRAX score) who wasworking to repair a trail in the Rocky Mountains. While other injurieswere more likely given the mechanism of injury and patient risk, thiscase highlighted the importance of considering tibial plateau fracture,even in atypical settings without significant risk. Improved awarenessof this mechanism of injury will lead to more accurate diagnosis andgreater post-injury management.

scholarly journals Hold Relax dan Passive Stretching Efektif Dalam Meningkatkan Kemampuan Fungsional Pada Pasien Post-Gips Fracture Tibial Plateau Dextra

2020 ◽  
Vol 3 (2) ◽  
pp. 16-23
Author(s):  
Nizatul Mumtazah ◽  
Faizah Abdullah
Keyword(s):  
Functional Ability ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
Single Case ◽  
Axial Loading ◽  
High Energy ◽  
Passive Stretching ◽  
Plateau Fracture ◽  
Muscle Groups

Background:  Tibial plateau fracture  is one type of fracture  that usually occur in legs.  Tibial Plateau fracture usually occur because of high energy trauma that produced by the force of varus and valgus and also because of axial loading or because of the pedestrian that crashed by the car with high energy which can also called as fracture bumber. The purpose of this case study is to examine  the effectiveness of hold relax and passive stretching in tibial plateau fracture. Method: A single case study, providing physiotherapy interventions for a 44 year old woman with a diagnosis of a tibial plateau post-cast fracture. Hold-relax stretching  is a technique in which shortened antagonistic muscle groups are isometrically contracted against the optimal resistance given by the physiotherapist. Passive stretching is a method for extending the contractile or non-contractile components of the musculotendinoeus unit where force is exerted externally and given manually. Hold relax and passive stretching are given for 2 weeks with 5 evaluations. ROM assessment was measured by a goniometer and spasm by palpation. Result: There is an increase in LGS knee flexion  90ᴼ to 110ᴼ and decrease in spasm which  associated with an improvement  LEFS score from 17 to 44, indicates that there is an increase in the functional ability of lower extremity. Conclusion: This study shows that the method of therapeutic exercise with hold relax and passive stretching can improve functional ability in tibial plateau fracture which is measured using LEFS parameters.

Posterolateral Fractures of the Tibial Plateau Revisited: A Simplified Treatment Algorithm

2020 ◽  
Author(s):  
Vincenzo Giordano ◽  
Robinson Esteves Pires ◽  
Frederico Silva Pimenta ◽  
Túlio Vinícius de Oliveira Campos ◽  
Marco Antônio Percope de Andrade ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Preoperative Planning ◽  
Proximal Tibia ◽  
Tibial Plateau Fracture ◽  
Treatment Algorithm ◽  
High Energy ◽  
Current Evidence ◽  
Force Magnitude ◽  
Plateau Fracture ◽  
Shear Type

AbstractHigh-energy fractures of the proximal tibia with extensive fragmentation of the posterolateral (PL) quadrant of the tibial plateau are challenging to manage. Herein, we present a review of the literature on the patterns and options of approach and fixation of the PL fragment of the tibial plateau to optimize the treatment of this specific injury pattern. We searched PubMed (1980–May 2020) to identify and summarize the most relevant articles evaluating both the morphology and treatment recommendations, including the choice of approach and fixation strategy, for the PL tibial plateau fracture. We found PL fragment can present in several patterns as a pure split, split depression, contained pure depression, and noncontained depression (rim crush), which are mostly determined by the position of the knee and the force magnitude applied during the course of the accident. Based on previous concepts described by Schatzker and Kfuri, we suggest a simplified treatment algorithm highlighting the two concepts (buttressing and containment) used for plating the PL tibial plateau fragments. Based on the available current evidence, we propose an algorithm for these two morphological types of PL tibial plateau fracture. Shear-type fractures need buttressing (the “rule of thumb”), whereas noncontained peripheral rim-type fractures need peripheral repair and containment. Contained pure depression fractures are not frequent and need percutaneous-assisted elevation and subchondral rafting, either controlled by fluoroscopy or arthroscopically. It is believed that such an approach would simplify their assessment and preoperative planning and would assist the clinicians to appreciate and manage more consistently these complex injuries.

Sign in / Sign up

Export Citation Format

Share Document