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