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Tibial Plateau Fractures
Posted: Jan 16 2019 #(C101155)
A

Tibia Plateau Fx in 50M

HPI

The patient brought to trauma bay following a MVC. He complains of knee pain isolated to the knee.

PMH

PE

Isolated Closed injury. Neurovascular Status is Intact.

Poll
1 of 7
1. Which classification system would you use to guide treatment?
None- they don't help guide treatment
9%
119/1211
Schatzker Classification
82%
999/1211
Hohl and Moore Classification
4%
53/1211
Other
3%
40/1211
2. What would be your definitive treatment plan for this fracture?
Hinged knee brace, PWB for 8-12 weeks
0%
3/862
External fixation/Ilizarov +/- limited open/percutaneous fixation of articular segment
10%
87/862
ORIF
89%
772/862
3. If performing ORIF, what position do you place patient?
Supine
91%
1024/1117
Prone
8%
93/1117
4. If performing ORIF, what approach would you use?
Single anterolateral
8%
97/1105
Dual incision
77%
858/1105
Extended Posteromedial
2%
31/1105
Single Anterior Midline
10%
114/1105
Single Posterior Midline
0%
5/1105
5. If performing ORIF, how do you address the large posterolateral lateral plateau?
From anterolateral approach
53%
575/1077
Extended posterolateral approach
35%
378/1077
Fibular osteotomy
3%
35/1077
Prone extended posteromedial approach
8%
89/1077
6. If performing ORIF, would you use a locking plate and screws?
Yes
94%
1003/1061
No
5%
58/1061
7. If performing ORIF, what would you use to fill the metaphyseal void?
Nothing
9%
104/1081
Autogenous bone graft (Iliac Crest)
33%
362/1081
Allogenic bone graft
23%
252/1081
Calcium phosphate bone substiture
29%
321/1081
Other bone graft substitute
3%
42/1081
PROCEDURE #1

ORIF - sequential prone/supine strategy

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OUTCOMES
Post-procedure P1
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