FRACTURES AROUND THE KNEEDR KIRAN PATIL

THIS PRESENTATION IS INTENDED FOR

• Discussing adult knee bony trauma• Excludes paediatric and geriatric population• Excludes associated injuries• Common and obvious injuries are stressed less.• Excludes pure ligamentous and soft tissue injuries around the

knee.

GENARAL CONSIDERATIONS ANATOMY APPEARS DIFFERENT IN MULTIPLE PLANES

GENARAL CONSIDERATIONS

• Femoral side injuries heal well relatively but are painful.• Femoral side injuries require careful observation to avoid

stiffness• Tibilal side injuries are less painful hence heal without

stiffness .• Tibial side healing is relatively poor ,hence bone grafting as

primary procedure should be considered whenever there is a gap or depression.

CT IS MANDATORY FOR IA FRACTURES AND DOUBTFUL INJURIES

X RAY

EASY WAY OF OBTAINING LAT VIEW

POSITIONING FOR X RAYS

MRI

• BONY AVULSION LIG INJURIES• RULE OUT NEOPLASM• TO RULE OUT INFECTION• PATHOLOGICAL FRACTURES• STRESS INJURIES

DISTAL FEMUR FRACTURE

• CONDYLE FRACTURES

• APPROACH A;UNIVERSAL MIDLINE B;DEPENDING ON FRACTURE

TECHNICAL CONSIDERATIONS

MEDIAL CONDYLE IS MORE DISTAL THAN LATERAL CONDYLE

LATERAL CONDYLE IS MORE ANTERIOR THAN MEDIAL CONDYLE

PROXIMAL TIBIA FRACTURE

SEAGONDS FRACTURE

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REVERSE SEAGONDS FRACTURE

ANTERIOR INJURIES

POSTERIOR INJURIES

PATELLA

• Don‘t just concentrate on bone

AXIAL VIEW IMPORTANT

PROXIMAL FIBULAR FRACTURE

• Treatment of these fractures is dictated by the associated ligamentous or neurovascular injury. Most injuries may be treated symptomatically in a hinged knee brace and appropriate pain control. Early knee motion should be encouraged.• The proximal fibula fracture in a Maisonneuve injury does not require stabilization.

However, the intraossesous and/or syndesmotic injury may require fixation near the ankle if the distal tibiofilular joint is unstable. Closed reduction and casting is an additional treatment option.• Open reduction and internal fixation may be indicated acutely for boney avulsions

of the LCL. Repair of associated posterolateral corner injuires to the knee can be stabilized at the same time

TIBIAL EMINENCE FRACTURE