Post on 21-Mar-2017
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