tibial fractures
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8/8/2019 Tibial Fractures
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T he tibia the most common
fractured long bone in the body
Fractures of the T ibial Plateu
Account for 1% of all fractures
Isolated lateral are the most common
Classified according to Schatzker
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S chatzker I Lateral split :
Split fracture of the lateral tibialplateau without depression.Etiology: Often due to valgus
stress. Occurs in younger patients with stronger bones,which are resistant todepression. Often due to abumper injury.Common associated injuries:Lateral meniscal tear. T he lateralmeniscus may also becomeentrapped in the fracture andrequire arthroscopy.T reatment: T ypically, lateral
fixation.
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S chatzker II S plit with
depressionM ost common tibial plateau fracture.Definition: Split depression of the lateral tibialplateau.
Etiology: Often due to valgus or axial stress.Occurs in older patients with osteoporosiswith bones that do not resist depression.Common associated injuries: Lateral
meniscus, medial meniscus, and medialcollateral ligament.T reatment: T ypically, lateral fixation. T hedepressed fragments are elevated andsupported with bone graft.
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S chatzker III Pure lateral
depressionDefinition: Lateral depressionEtiology: Older patients withosteoporosis. Often just due to afall.Common associated injuries: If thedepressed fragments are lateraland posterior, it is associated with
joint instability.
T reatment: If there is instability, thefractured fragments are elevatedand supported with bone graft andlateral internal fixation.
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S chatzker IV Pure medial
depressionDefinition: M edial tibial plateau fracture thatmay be a split or split depression typefracture. M ay also involve the tibial spines.Etiology: Varus stress. Often severe
trauma.Common associated injuries: Associatedwith avulsion of the intercondylar eminence,which may indicate anterior cruciateligament injury. Lateral collateral ligament
injury. Peroneal nerve injury. Poplitealartery injury.T reatment: M edial plate and screws.
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S chatzker V Bicondylar
Definition: Split medial and lateraltibial plateau (Bicondylar).M etaphysis is still in continuity withthe diaphysis.Etiology: Often pure axial stress withsevere trauma.Common associated injuries:Neurovascular, ACL, and meniscalinjuries.T reatment: T ypically, medial andlateral internal fixation.
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S chatzker VI S plit extends to
metadiaphysisDefinition: M etaphyseal fracture thatseparates the articular surface fromthe diaphysis. M ay involve themedial, lateral, or both articular
surfaces.Etiology: High-energy trauma.Common associated injuries:
Neurovascular injury andcompartment syndrome. Alsomeniscal, ACL, and collateralligament injuries.T reatment: T ypically medial andlateral internal fixation.