- Discussion:
- plays a role in intertroch stability;
- evaluate size & displacement of lesser troch before judging instability;
- lesser troch has a postero-medial location and when this structure is
frx & displaced, defect results at post medial aspect of frx surfaces;
- axial loading studies of
Unstable frx have confirmed that posteromedial
frag (PMF) is keystone to mechanical stability and attempts should be made
to include this fragment w/ internal fixation;
- Radiographs:
- medial defect promotes varus angluation
- posterior defect promotes retroversion
- either of these may cause bending, breaking, or cutting out of implant;
- Treatment:
- when anatomic reduction is possible, fixation of the PMF becomes
progressively more important as its size increases;
- need to treat these fractures as
unstable
