M.E.Müller: Atlas: Fracture 41-C3

Tibia/Fibula, Proximal,
complete articular fracture,
articular multifragmentary
0,53% of the total
2,73% of the tibia
10,99% of the segment

214 fractures
74,3% group
52%M, 48%F

24 fractures
8,3% group
61%M, 39%F

50 fractures
17,4% group
68%M, 32%F

Lateral +Q Medial +Q Lateral and medial +Q

These are complete articular fractures of the proximal tibia, multifragmentary, involving the articular surface of the lateral tibial plateau. The metaphyseal fracture, either simple or complex, has no influence in the subgroup and will be expressed by its qualifications: in this case (5) for a metaphyseal-diaphyseal complex fracture. Ref. Manual of Internal Fixation:
208 - 213. 568 - 577.
Surgeon. RO.

All of the fractures of this group are very difficult to reconstruct because of the extensive involvement of the articular surface; some of them are unreconstructable and will end up in an arthrodesis or in a joint replacement.

Anatomic reduction of the articular surface and maintenance of the diaphyseal axis are essential in order

to obtain good long term results. In the illustrated case, first the metaphyseal-diaphyseal fracture was reconstructed by anatomic reduction and internal fixation with a long medial plate that brings the axis into line and simplifyes the fracture. The lateral tibial plateau was then reduced over the distal reconstructed segment, supported by a lateral buttress plate and compressed by screws placed through the medial plate.

preoperative preoperative

postoperative postoperative

+ 1 year + 1 year




						Tibia/Fibula, Proximal, complete articular fracture, articular multifragmentary	0,53% of the total 2,73% of the tibia 10,99% of the segment






These are complete articular fractures of the proximal tibia, multifragmentary, involving the articular surface of the lateral tibial plateau. The metaphyseal fracture, either simple or complex, has no influence in the subgroup and will be expressed by its qualifications: in this case (5) for a metaphyseal-diaphyseal complex fracture.		Ref. Manual of Internal Fixation: 208 - 213. 568 - 577. Surgeon. RO.

All of the fractures of this group are very difficult to reconstruct because of the extensive involvement of the articular surface; some of them are unreconstructable and will end up in an arthrodesis or in a joint replacement. Anatomic reduction of the articular surface and maintenance of the diaphyseal axis are essential in order	to obtain good long term results. In the illustrated case, first the metaphyseal-diaphyseal fracture was reconstructed by anatomic reduction and internal fixation with a long medial plate that brings the axis into line and simplifyes the fracture. The lateral tibial plateau was then reduced over the distal reconstructed segment, supported by a lateral buttress plate and compressed by screws placed through the medial plate.