tibial plateau pre-webinar cases

These cases are are to get you to start thinking and questioning your knowledge ahead of the webinar on tips, tricks & tactics for tibial plateaus.

We are joined for this 360 degree educational event by:

Let’s get straight into it

Case 1 – Elderly tibial plateau fracture

76yo woman. Independently mobile. PMH of hypertension but otherwise fit and well. Falls getting out of a car sustaining bilateral tibial plateau fractures.

Right knee:

How are you going to definitively treat the RIGHT knee?

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How are you going to manage the WBing status of the RIGHT knee?

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Left knee:

How are you going to definitively treat the LEFT knee?

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How are you going to manage the WBing status of the LEFT knee?

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Which of the following do you consider appropriate indications for TKA in the management of tibial plateau fractures in the elderly? (you can select more than one)

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If you consider arthroplasty in either knee, how are you going to manage the lateral defect?

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Case 2: lateral tibial plateau

43yrs alcoholic male.  Injured during a skirmish outside his local bar

Question 1.  Surgery or not?

Given this chap could be a bit unreliable, is this a fracture that could be reasonably treated non-op?

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Question 2.  Timing of surgery

At the MDT, the decision was made to fix the fracture. The knee is swollen but no blisters or obviously threatened skin. When to intervene?

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Question 3. How to fix

What do you envision your final x-ray is going to look like?

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Case 3 – lateral plateau

72 year old female with hypertension. Gets struck on the left leg by her unruly, fast running Labrador, whilst out for a walk.

In the reasonably healthy older patient, such as this lady, does your strategy change at all when treating plateau fractures?
(For each section, tick the option that most closely resonates with your management)

Op vs Non-op

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Fixation

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Bone substitute

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Mobilisation

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Case 4 – lateral and medial plateau

21 yrs female, fit and well, crashed her off-road motorbike while doing an attempted log-jump drop-off.
Soft tissues are good, she’s slim and NV intact.
Have a run though the imaging and see what you think

Regarding the medial condyle fracture, which of the following options most closely resonates with your general approach and positioning

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Regarding the postero-lateral joint depression

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Post-operatively, which of the following do you think this lady will most likely struggle with?

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Webinar

Please post your thoughts about these cases in the comments section below.

For the answers to these questions and much more join our webinar this week, Wednesday 25th November at 8pm GMT.

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6 Responses

  1. wonderful cases and perspectives , the post op management is hardly ever discussed . management options and elderly cases is interesting

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