Tibial Plateau Essay

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The tibial plateau is one of the most important load bearing areas in the body. Fractures of the medial or lateral condyles of the proximal tibia have a profound effect on stability and motion, and also affect the knee joint despite supporting ligaments being usually unaffected. Fractures of the tibial plateau in older people are commonly due to low energy trauma to osteoporotic bone resulting in a depressed fracture. In younger people, fractures may occur as a result of a high-energy valgus force on the leg with axial loading, most commonly following a road traffic accident.

Tibial plateau fractures are characterised using the Schatzker classification system, which describes six types of fracture differing in complexity and in the extent of involvement of the medial plateau. This system helps to guide the choice of treatment required. Non-operative treatment such as functional cast bracing is usually suitable …show more content…

Internal fixation is carried out following open reduction (ORIF) except in circumstances where extensive comminution has occurred or soft tissue has been damaged. In this case circular external fixators may be used following a ligamentotaxis reduction. In elderly people who are unsuitable for ORIF a total knee arthroplasty may be considered. ORIF involves the realignment of the tibial plateau followed by fixation with a buttress or tibial locking plate and screws along the lateral surface of the tibia. This method can be used to rectify all Schatzker type fractures, and is associated with satisfactory clinic and functional outcomes. ORIF also aims to prevent the development of post-traumatic arthritis. However, possible complications such as compartment syndrome, vascular injury and knee stiffness must be considered with ORIF as well as with other surgical

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