Tibial plateau fractures
A 34y/o Female presents to your office with acute left knee pain and swelling for the past 48hrs. She reports an axial load type injury to the knee when stepping down from her deck which is approximately 2ft from ground level. She was immediately incapacitated by pain and unable to bear weight. The patient’s physical exam is quite impressive with a 1+ effusion and a profound loss of flexion. She guards against passive motion and is extremely tender throughout the joint. Provocative testing is useless in this case due to patient guarding. Preliminary AP and Lateral radiographs of the knee demonstrates a split and depressed lateral plateau fracture with medial extension. A subsequent CT scan confirms a bicondylar tibial plateau fracture.
#1- Can you name the fracture classification?
#2- How would you immobilize the patient awaiting surgical stabilization?
#3- What is the most likely prognosis for this injury?
1. Schatzker types I-VI
2. In line immobilization with bracing or splinting
3. Early onset of Post-Traumatic Arthritis