M.E.Müller: Atlas: Fracture 41-B2

Tibia/Fibula, Proximal,
partial articular fracture,
pure depression
0,61% of the total
3,18% of the tibia
12,78% of the segment

133 fractures
39,7% group
39%M, 61%F

144 fractures
43,0% group
39%M, 61%F

58 fractures
17,3% group
53%M, 47%F

Lateral total +Q Lateral limited +Q Medial +Q

These are depression fractures of the proximal tibia involving the whole lateral plateau without a longitudinal fracture line component (pure depression). Ref. Manual of Internal Fixation:
184 - 187. 208 - 213. 568 - 576.
Surgeon. CS, CS.

Anatomic reduction is essential and it is obtained by making a window in the lateral cortex of the tibia, underneath the depressed area, through which the articular surface is pushed up until slight overcorrection is attained. The loss of bone stock due to the crushing must be substituted by abundant bone graft, either autologous or freeze-dried, adequately compressed

in order to obtain an efficacious buttress function.

Several cancellous screws supported by washers or a plate form the scaffold for the bone graft and reinforce the weakened cortex.

preoperative postoperative +1 year

preoperative postoperative +1 year

preoperative + 0 months +1 year

These are depression fractures of the proximal tibia involving a limited area of the lateral tibial plateau, with preservation of the cortices. Ref. Manual of Internal Fixation:
208 - 213. 568 - 576.
Surgeon. RO.

In the illustrated case, the CTscan demonstrates the central and posterior depression of the lateral tibial plateau and the preservation of the cortices. The reduction is obtained in the same manner as in the previous subgroup and can be visually monitored, either arhroscopically or through a submeniscal approach.

In this case, the bone graft used was freeze-dried and the delicate epiphyseal cortex is buttressed by a small plate through which two screws reinforce the framework of the depressed area..

preoperative

+ 3 months + 3 months

+ 6 months + 6 months

preoperative preoperative

+ 1 year 6months + 1 year 6months

preoperative preoperative

+ 1 year + 1 year

preoperative preoperative preoperative

preoperative + 3 months + 3 months

+ 1 year + 1 year




						Tibia/Fibula, Proximal, partial articular fracture, pure depression	0,61% of the total 3,18% of the tibia 12,78% of the segment






These are depression fractures of the proximal tibia involving the whole lateral plateau without a longitudinal fracture line component (pure depression).		Ref. Manual of Internal Fixation: 184 - 187. 208 - 213. 568 - 576. Surgeon. CS, CS.

Anatomic reduction is essential and it is obtained by making a window in the lateral cortex of the tibia, underneath the depressed area, through which the articular surface is pushed up until slight overcorrection is attained. The loss of bone stock due to the crushing must be substituted by abundant bone graft, either autologous or freeze-dried, adequately compressed	in order to obtain an efficacious buttress function. Several cancellous screws supported by washers or a plate form the scaffold for the bone graft and reinforce the weakened cortex.






These are depression fractures of the proximal tibia involving a limited area of the lateral tibial plateau, with preservation of the cortices.		Ref. Manual of Internal Fixation: 208 - 213. 568 - 576. Surgeon. RO.

In the illustrated case, the CTscan demonstrates the central and posterior depression of the lateral tibial plateau and the preservation of the cortices. The reduction is obtained in the same manner as in the previous subgroup and can be visually monitored, either arhroscopically or through a submeniscal approach.	In this case, the bone graft used was freeze-dried and the delicate epiphyseal cortex is buttressed by a small plate through which two screws reinforce the framework of the depressed area..