tibial plateau fracture

By Ophavanh Inthirath | 19 Jun, 2017

the patient motor vehicle accident come and present with deformity of knee, swelling , pain and limited rang of motive



Jessica Hirschhorn Replied at 8:05 AM, 19 Jun 2017

AP and lateral x-ray?

Jennifer Lucas Replied at 8:14 AM, 19 Jun 2017

Who is the ideal medical practitioner to see the patient? Orthopedic
surgeon, plaster technician, physiotherapist?

*Benson Sewe Otieno| Executive Officer | Sagam Community Hospital

Jessica Hirschhorn Replied at 8:18 AM, 19 Jun 2017

Need to see x rays.  However, with deformity as described, likely markedly displaced fracture.  Needs evaluation by ORTHO SURGEON.

Rameez Qudsi Replied at 7:04 PM, 19 Jun 2017

Must confirm it is a closed fracture (if open fracture needs immediate
antibiotics and likely immediate surgery for irrigation/debridement).
Depending on Xrays may need surgery or splint/cast.

Can take discussion offline if you would like to review further with XRays,
feel free to email me separately:

Robert Goodman Replied at 11:40 PM, 19 Jun 2017

History: You need to know if the patient was a passenger in vehicle or on motorcycle, or was he a pedestrian. Answer helps in determining the severity of the injury.
Physical: Is the knee unstable, open wound, crepitus, distal neuro-vascular compromise?
X-rays of knee: are fractures displaced? Are joint surfaces disrupted?
Treatment: Non- displaced,closed fractures can be treated with a cast for 4-6 weeks non weight bearing, then begin gentle range of motion. Begin progressive weight bearing at 6-8 weeks.
If fracture is open I agree with Rameez's recommendation.
If there is a displaced intraarticular fracture, it requires open reduction internal fixation to prevent persistent pain, instability,severe arthritis.