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Discusión entre pares / 45 yrs male, motorcycle accident, 12 days old tibial plateau fracture schatzker 5, ao 41c31, closed reduction, ligamentotaxis…
45 yrs male, motorcycle accident, 12 days old tibial plateau fracture schatzker 5, ao 41c31, closed reduction, ligamentotaxis, fixed by cannulated hip screw. Expert comments plz n also future management???
Manpal NarulaWe all know what kind of fixation this is and the poor prognosis if we leave it like this . Needs lateral buttress plate with elevation and BG .posteromedial separate plate is must through a sep incision. Please try to get ct scan in these fractures
Jai Vardhan SinghBicondylar fracture,coronal split of medial condyle, with significant articular depression ( more on post-op)and communition. Posteriomedial Buttressing should be done with BG+ additional buttress plate/ screws from lateral side.
Narayana PrasadIt’s a classical example how a case may be buggered up. Is there any pre op CT available ? How can u manage a type 5 scht. With this kind of fixation? You should boldly go head and redo it without any hesitation. Patient may be unhappy for the time being when you ask for a redo, if you don’t do it he will be ur lifelong enemy.
Schatzker type 5 even though it looks more benign preop, Ideally, after soft tissue improve, open reduction is needed with reduction of depression and fix it with subcondral screws and a lateral hokey plate preferably LCP. Another postero medial small fragment semitubular plare may be needed. Avoid cast as possible and start early ROM. Another method is a ring fixation.
Mustafa Abdelhaleemthere is a central dep. in the art. surface of lat. condyle and not reduce , needs grafting and batrous plate + no compression was done , soon revision should be done by grafting and batrous plate in the lat. side with another 2 short serrated cancellous screws in the medial condyle
DrHrishikesh MahadikAriticular surface is not reduced. Patient will develop OA knee in future. Should have used stienmann pin as a joystick to reduce the fracture and bone clamp to hold it before putting the cannulated screws.. Did u use traction table???
Anil MittalCt is must 3d. Then treat on table heavy traction with calc. Pin and then pass a cannulated screw by closed means from lat. Side under c arm. Then fix med cond by ao 3.5 upper tibia postero medial plate
Narayana PrasadThe key in this type of fracture is the reconstruction of posterio medial corner o some time the posterior wall itself. Without a proper CT we cannot go further at all. I feel it’s criminal to do such fixation and invite litigation