Tibial plateau fracture: Difference between revisions
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**Avulsion fracture of margin of lateral tibial plateau just below joint line | **Avulsion fracture of margin of lateral tibial plateau just below joint line | ||
**Associated w/ tear of ACL and meniscal ligaments | **Associated w/ tear of ACL and meniscal ligaments | ||
==Clinical Features== | |||
==Differential Diagnosis== | |||
{{Knee DDX}} | |||
{{Distal leg fractures DDX}} | |||
==Diagnosis== | ==Diagnosis== | ||
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===Schatzker Classification=== | ===Schatzker Classification=== | ||
[[File:Schatzker Classification.jpg|thumb|Schatzker Classification of Tibial Plateau Fractures]] | |||
*Schatzker I Lateral split | *Schatzker I Lateral split | ||
*Schatzker II Split with depression | *Schatzker II Split with depression | ||
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*Schatzker V Bicondylar | *Schatzker V Bicondylar | ||
*Schatzker VI Split extends to metadiaphysis | *Schatzker VI Split extends to metadiaphysis | ||
==Management== | ==Management== | ||
*Knee immobilizer | *Knee immobilizer with non-weightbearing and ortho referral in 2-7d | ||
==Disposition== | ==Disposition== | ||
Revision as of 13:40, 1 April 2016
Background
- Occurs via axial load that drives femoral condyle into tibia
- ACL and MCL injuries assoc w/ lateral plateau fracture
- PCL and LCL assoc w/ medial plateau fracture
- Compartment syndrome may occur
- Segond Fracture
- Avulsion fracture of margin of lateral tibial plateau just below joint line
- Associated w/ tear of ACL and meniscal ligaments
Clinical Features
Differential Diagnosis
Knee diagnoses
Acute knee injury
- Knee dislocation
- Knee fractures
- Meniscus and ligament knee injuries
- Patella dislocation
- Patellar tendonitis
- Patellar tendon rupture
- Quadriceps tendon rupture
Nontraumatic/Subacute
- Arthritis
- Gout and Pseudogout
- Osgood-Schlatter disease
- Patellofemoral syndrome (Runner's Knee)
- Patellar tendonitis (Jumper's knee)
- Pes anserine bursitis
- Popliteal cyst (Bakers cyst)
- Prepatellar bursitis (nonseptic)
- Septic bursitis
- Septic joint
- DVT
Distal Leg Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Diagnosis
Imaging
- AP, lateral, oblique views (internal for lateral plateau, external for medial plateau)
- AP - line drawn at lateral margin of femur should not have >5mm of tibia beyond it
- CT or MRI should be considered if plain film negative but high clinical suspicion
Schatzker Classification
- Schatzker I Lateral split
- Schatzker II Split with depression
- Schatzker III Pure lateral depression
- Schatzker IV Pure medial depression
- Schatzker V Bicondylar
- Schatzker VI Split extends to metadiaphysis
Management
- Knee immobilizer with non-weightbearing and ortho referral in 2-7d
Disposition
- Indications for referral within 48hr:
- Significant displacement or depression
- Suspected or documented ligamentous injury
See Also
Source
- Tintinalli