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Dr. L.A Ledwaba
Plateau Tibial Fracture
Dr. L.A Ledwaba
Epidemiology
Common young male
elderly females
Dr. L.A Ledwaba
Location:
Lateral
Bicondylar
Medial
Dr. L.A Ledwaba
Mechanism of injury
Varus load
Vulgus load
Axial load
Dr. L.A Ledwaba
Associated condition
Meniscal tear
Tibial fracture
Compartment syndrome
Crutiate ligament
Dr. L.A Ledwaba
Anatomy
1. Osteotogy - Lateral - Medial - Tibial spine
60% weight bearing medial
• 2. Collateral ligament
Dr. L.A Ledwaba
Clinical presentation
Physical examination – inspection: - Rule out an open injury
- Palpation - Consider compartment syndrome
- Laxity >10 degrees equals instability
Dr. L.A Ledwaba
CLASSIFICATION
SCHATZKER CLASSIFACTION
HOHL AND MOORE
Dr. L.A Ledwaba
Schatzker classification
Lateral split
Sphit depression
Depression
Medial condyl
Bicondylar
Metaphyseal -diaphysial
Type I
Type II
Type III
Type IV
Type V
Type VI
Dr. L.A Ledwaba
Lateral split fracture
Dr. L.A Ledwaba
Spilt-depression fracture
Dr. L.A Ledwaba
Pure depression fracture
Dr. L.A Ledwaba
Medial plateau fracture
Dr. L.A Ledwaba
Bicondylar fracture
Dr. L.A Ledwaba
Metaphyseal-diaphyseal disassociation
Dr. L.A Ledwaba
Hohl and Moore
Type I Coronal split
Type II Entire condylar fracture
Type III Rim Evulsion
Type IV Rim compression
Type V four part fracture
Dr. L.A Ledwaba
X-ray Optional plateau view
AP viewLateral viewOblique
Caudal tilt
Imaging
Dr. L.A Ledwaba
CT scan MRI /angiogram
ComminutionDepressionLipohemarthrosis
Meniscal Ligament pathologyVascular injury
IMAGING
Dr. L.A Ledwaba
Treatment
Non-operative
- POP
- Hinged knee brace
- Skin traction
Dr. L.A Ledwaba
Non-operative
Articular step <3mmCondylar split <3mm
Stable kneeHINGED BRACE
Crutch Pwb 8-10weeks
Dr. L.A Ledwaba
Operative treatment
1. Medial plateau
2. Bicondylar
Stepoff 3mm
3-5mm widening
Dr. L.A Ledwaba
External Fixation
Open fracture with contamination
Comminution