·
axial loading (e.g. fall from height)
·
femoral condyles driven into proximal tibia
·
can result from minor trauma in osteoporotics
·
lateral fractures more common than medial
·
Schatzker classification
·
x-rays: AP, lateral, skyline
·
if depression on x-ray is <3 mm
straight
leg immobilization x 4-6 weeks with progressive ROM weight bearing
·
if depression is >3 mm
ORIF
often requiring bone grafting to elevate depressed fragment
·
ligamentous injuries
·
meniscal lesions
·
AVN
·
infection
·
nunerous, including MVA, falls, sporting injuries
·
open vs. closed
·
amount of displacement
·
neurovascular status
·
most commonly fractured long bone
·
most common open fracture
·
x-rays: AP, lateral. skyline
·
closed
• minimally displaced: straight leg cast x 4-6
weeks with early weight bearing
• diapla.ced: ORIF with reamed IM nail. plate
and screws, or external fimtor
·
open
• external fixation or IM nail
• vascularized coverage of soft tissue defects
(often heal poorly)
·
high incidence of neurovascular injury and
compartment syndrome
·
poor soft tissue coverage
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