Tibial Plafond Fracture Classification - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 9 ม.ค. 2018
- Dr. Ebraheim’s educational animated video describes tibial plafond fracture classifications.
Ruedi -Allgower classification
Type I
•No significant joint incongruity.
•Cleavage fracture with no displacement of the fractured fragments.
Type II
•Significant incongruity.
•Minimal metaphyseal comminution or impaction.
Type III
•Significant articular comminution and metaphyseal impaction (bad injury).
AO/OTA classification
1-A extra-articular
2-B partial-articular
3-C complete articular
I don’t think you can go wrong with classifying any fracture that involves or close to a joint as an extra-articular, partial-articular or complete articular.
A extra-articular
•A1 metaphyseal simple
•A2 metaphyseal wedge
•A3 metaphyseal complex
All of these extra-articular fractures are named A based upon the complexity of the fracture.
B partial articular
•B1 pure split
•B2 split depression:
Supination/abduction fracture of the ankle will have a vertical fracture of the medial malleolus.
The anteromedial portion of the plafond may also be impacted.
This fracture shows up in classic orthopedic examinations.
This impaction or depression can be missed.
What would you do after fixation of this fracture and the impaction fracture is missed?
You probably need to revise the fixation and make sure to elevate the impaction or depression.
Restore the joint congruity before fixing the fracture.
When you fix the fracture, fix it with a plate or with screws.
oThe screws have to be parallel to the joint to compress the fracture.
Plate fixation should be done with an antiglide plate.
•B3 multi-fragmentary depression
C complete articular
•C1 articular simple, metaphysis simple
•C2 articular simple, metaphysis multi-fragmentary
•C3 articular multi-fragmentary, metaphysis multi-fragmentary. Difficult fracture with the worse prognosis.
Classically, there is a typical pilon fracture fragments. Usually, there are three main joint fragments. The three fragments are:
1-Medial malleolus: attached to the deltoid ligament.
2-Anterolateral fragment: Chaput fragment (attached to the anterior inferior tibiofibular ligament).
3-Volkman fragment: posterolateral fragment attached to the posterior inferior tibiofibular ligament.
In this CT scan, you can see the three fragments of the pilon fracture as well as joint impaction.
When the fibula is intact, the lateral collateral ligament of the ankle may rupture (fibula is intact in 20% of the cases)
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That was so useful sir.
Thank you sir
Good morning Dr.Nabil I enjoy your very nice videos but one question if I may if someone has tibia plateau fracture is it the same as plafond you are referring? or different issues my concern is this I have been told you will have artheritis of the knee anytime. Is that the case. I am over 60 and still have metal fixture and numbers of screws in it and consider remove it after 7years it is limitating. a bit soreness on the inner side on the tendon. is there a problem taking of the fixture few years down the line. Just an opinion thanks for your attention
Tibial plateau means fracture of proximal part of tibia that is the upper portion of tibia that is a part of knee joint. Plafond refers to distal part of tibia that lies near the ankle and forms the ankle joint
doc. est ce que nous cherchons dans notre bilan d'une marche ébrieuse?
Sir
My leg left leg orif fracture
C3 type your video according
Tibia and fifula
How many days recovery