M.E.Müller: Atlas: Fracture 41-A3

Tibia/Fibula, Proximal,
extra-articular fracture,
metaphyseal multifragmentary
0,15% of the total
0,78% of the tibia
3,13% of the segment

20 fractures
24,4% group
65%M, 35%F

16 fractures
19,5% group
81%M, 19%F

46 fractures
56,1% group
74%M, 26% F

Intact wedge +Q Fragmented wedge +Q Complex +Q

These are extra-articular multifragmentary fractures of the proximal tibial metaphysis. Ref. Manual of Internal Fixation:
208 - 213. 568 - 577.
Surgeon. RO.

They are usually associated to a fracture of the fibula that must be reduced and fixed in order to reconstitute the lenght of the tibial segment and increase its stability.

Reduction can be achieved either with the distraction device or manually with the help of a lateral plate, previously contoured and fixed to the large proximal fragment, to which the distal fragment is aligned and the intermediate fragments are reduced. Since there is no

contact between the proximal and distal fragments, it is mandatory to place a medial plate (contralateral, double-plate) in order to neutralize the varus stresses.

It is usually necessary to use autologous bone graft in order to compensate for the relative loss of bone stock caused by the multifragmentation of the metaphyseal cortex.

preoperative preoperative

postoperative postoperative

+ 5 months + 5 months

+ 2 years + 2 years

preoperative preoperative

+ 1 years + 1 years




						Tibia/Fibula, Proximal, extra-articular fracture, metaphyseal multifragmentary	0,15% of the total 0,78% of the tibia 3,13% of the segment






These are extra-articular multifragmentary fractures of the proximal tibial metaphysis.		Ref. Manual of Internal Fixation: 208 - 213. 568 - 577. Surgeon. RO.

They are usually associated to a fracture of the fibula that must be reduced and fixed in order to reconstitute the lenght of the tibial segment and increase its stability. Reduction can be achieved either with the distraction device or manually with the help of a lateral plate, previously contoured and fixed to the large proximal fragment, to which the distal fragment is aligned and the intermediate fragments are reduced. Since there is no	contact between the proximal and distal fragments, it is mandatory to place a medial plate (contralateral, double-plate) in order to neutralize the varus stresses. It is usually necessary to use autologous bone graft in order to compensate for the relative loss of bone stock caused by the multifragmentation of the metaphyseal cortex.