Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Restoration of joint stability
62%
1066/1710
Repair of associated meniscal pathology
3%
46/1710
Surgical fixation within 48 hours of injury
0%
7/1710
Correction of the articular depression
27%
465/1710
Tibial condylar diastasis < 3 mm
7%
116/1710
Select Answer to see Preferred Response
The clinical presentation and imaging studies are consistent with a tibial plateau fracture. Restoration of joint stability has been shown to be the strongest predictor of long term outcomes. Honkonen reviewed 131 tibial condyle fractures and determined that articular stepoff <3mm and tibial widening <5mm did not negatively effect outcomes. In contrast, 70% of knees with moderate to severe malalignment went on to functionally unacceptable outcomes. They suggested operative fixation for all medial uni and bicondylar fractures, any lateral fractures with >5 degrees of valgus tilt, >3mm of articular depression, >5mm of condylar widening, or >5 degrees of valgus malalignment. In the Marsh et al JAAOS symposium review, the authors noted that fractures with up to 10mm of articular depression and joint stability obtained acceptable functional outcomes. They also cited a 20 year follow-up which indicated that articular step-off alone was not a predictor of poor long-term results. More importantly, when instability is present with other factors, including step-off and central depression, poor results followed. Illustrations A and B show the intraoperative films. Illustration C reviews the Schatzker classification system.
3.0
(45)
Please Login to add comment