- See:
-
Post Operative Care and Compications:
-
Rim Fractures:
-
Knee Dislocations:
- Discussion:
- frx dislocations of tibial plateau will have assoc:
-
ligamentous injuries;
- meniscal injuries, which are usually not repairable;
- N/V injuries, increasing from 2% for type I to 50% for type V, w/ an
overall avg of 15%, approx that of classic knee dislocation;
- Radiographs:
- Type I - Coronal Split Fracture:
- account for 37% of tibial plataue fracture dislocations;
- frx involves
medial plateau, is apparent on the lateral view, w/ frx line
running at 45 deg to medial plateau in oblique coronal transverse plane;
- frx may extend to lateral side, & may include
avulsion frx of fibular styloid,
avulsion of the cruciates, and Gerdy's tubercle are common;
- Treatment:
-
PreOp Planning
- these frxs frequently require require closed reduction & percutaneous
screw fixation to improve reduction & allow early ROM in cast brace;
- if ORIF is required, fragment usually reduces in extension & can be fixed w/
interfragmentary screws;
- assoc
ligamentous injuries can be repaired along w/ capsular disruption;
- protected wt bearing is continued for 8 to 10 weeks;
- Post Operative Care and Compications:
