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This is a medial tibial plateau fracture with a split or depressed component. It is usually the result of a high energy injury and involves a varus force with axial loading at the knee. Represent 10% of all tibial plateau fractures. There is high risk of damage to the popliteal artery and peroneal nerve and therefore carry a worse prognosis.
Fractures of the knee are less common but should be considered if direct trauma to the knee has occurred such as during a fall. Examples of fractures involving knee joints are: tibial plateau fractures, fractures of the lateral condyle of femur, medial condyle of femur, and patellar fractures. [1]
The bony congruity of the medial knee consists of the opposing surfaces of the medial femoral condyle and the medial tibial plateau. On the medial femoral condyle there are three bony landmarks that are important: the medial epicondyle, adductor tubercle, and gastrocnemius tubercle. The medial epicondyle is the most distal and anterior prominence.
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A tib-fib fracture is a fracture of both the tibia and fibula of the same leg in the same incident. In 78% of cases, a fracture of the fibula is associated with a tibial fracture. [6] Since the fibula is smaller and weaker than the tibia, a force strong enough to fracture the tibia often fractures the fibula as well. Types include:
The location of the removed wedge of bone depends on where osteoarthritis has damaged the knee cartilage. The most common type of osteotomy performed on arthritic knees is a high tibial osteotomy, which addresses cartilage damage on the inside (medial) portion of the knee. The procedure usually takes 60 to 90 minutes to perform. [9]
The tibia is then drawn forward anteriorly. An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point may indicate either a sprain of the anteromedial bundle or complete tear of the ACL. [2] If the tibia pulls forward or backward more than normal, the test is considered positive.
A Salter–Harris fracture is a fracture that involves the epiphyseal plate (growth plate) of a bone, specifically the zone of provisional calcification. [2] It is thus a form of child bone fracture. It is a common injury found in children, occurring in 15% of childhood long bone fractures. [3]