Knee fractures: Difference between revisions

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==Background==
==Background==
*Most pts with severe ligamentous or meniscal injury have normal radiographs
[[File:Knee diagram2.png|thumb|Anatomy of anterolateral aspect of right knee.]]
*Lipohemarthrosis suggests occult fx
*Most patients with severe ligamentous or meniscal injury have normal radiographs
*Lipohemarthrosis suggests occult fracture
**Lateral view: Fat-fluid level indicates intra-articular fracture  
**Lateral view: Fat-fluid level indicates intra-articular fracture  
===Types===
*[[Patella fracture]]
*[[Tibial plateau fracture]]
*[[Segond fracture]]


==Differential Diagnosis==
==Differential Diagnosis==
{{Knee DDX}}
{{Knee DDX}}
==[[Patella fracture]]==
==[[Tibial plateau fracture]]==
===Background===
*Occurs via axial load that drives femoral condyle into tibia
*ACL and MCL injuries assoc w/ lateral plateau fx
*PCL and LCL assoc w/ medial plateau fx
*Compartment syndrome may occur
*Segond Fracture
**Avulsion fx of margin of lateral tibial plateau just below joint line
**Associated w/ tear of ACL and meniscal ligaments
===Imaging===
*AP, lateral, oblique views (internal for lateral plateau, external for medial plateau)
**AP - line drawn at lateral margin of femur should not have >5mm of tibia beyond it
*CT or MRI should be considered if plain film negative but high clinical suspicion
===Schatzker Classification===
*Schatzker I Lateral split
*Schatzker II Split with depression
*Schatzker III Pure lateral depression
*Schatzker IV Pure medial depression
*Schatzker V Bicondylar
*Schatzker VI Split extends to metadiaphysis
[[File:Schatzker Classification.jpg|thumb|Schatzker Classification of Tibial Plateau Fractures]]
===Management===
*Knee immobilizer w/ non-weightbearing and ortho referral in 2-7d
===Disposition===
*Indications for referral within 48hr:
**Significant displacement or depression
**Suspected or documented ligamentous injury


==See Also==
==See Also==
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*[[Knee (Main)]]
*[[Knee (Main)]]


== Source ==
==References==
*Tintinalli
<references/>
 


[[Category:Ortho]]
[[Category:Orthopedics]]

Latest revision as of 21:41, 21 May 2020