[ORT-L] Proximal tibia fracture


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[ORT-L] Proximal tibia fracture

alex61 at gmail
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Aug 6, 2007, 9:16 AM

Post #1 of 7 (3518 views)
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[ORT-L] Proximal tibia fracture	Can't Post

Dear colleagues

Pls advise on management of proximal tibia injury in a 27 y.o. male
2 weeks after RTA. Images attached. What approach and what fixation
would be your choice?

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

Attachments:

062.jpg (45.9 KB)

061.jpg (10.9 KB)

vrid at euronet
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Aug 6, 2007, 10:50 AM

Post #2 of 7 (3518 views)
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Re: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

Alexander, about 3 yr ago the posterior approach to the knee and
tibiaplateau was published in JOT. Since then i have used the
approach several times with good results, you have limited view and
space to maneuver but sufficient!

Greetings Victor de Ridder, The Netherlands.

Victor de Ridder
SFG afd. Heelkunde/Traumatologie
Kleiweg 500
3045PM Rotterdam
010-4616161 pieper 3105
06-53123763
vrid@euronet.nl

On 6 aug 2007, at 18:16, alexander chelnokov wrote:

> Dear colleagues
>
> Pls advise on management of proximal tibia injury in a 27 y.o. male
> 2 weeks after RTA. Images attached. What approach and what fixation
> would be your choice?
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
> <062.jpg>
> <061.jpg>

nswolfso at usc
New User

Aug 6, 2007, 11:24 AM

Post #3 of 7 (3518 views)
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Re: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

Dear Alex:

Thanks for sharing this case.
Based on the images ( it would be nice to have axial cuts),it seems to be posteromedial fragment, almost all the way into posterior portion of the tibial eminance.

Approach: posteromedial, but you have to open the joint, since the fragment is small and there will be an issue with the medial meniscus ( likely torn).

The appearance of the fragment is indicative of a shearing injury, so you will need small screws ( hand set ) that will have to be subchondral, or, start from the back and transfix the fragment going into anteroinferior direction. MRI might be sometimes useful to assess integrity of the ligaments. I hope there is no vascular issues.

Good luck.

Nikolaj

Nikolaj Wolfson, MD, FRCSC
Assistant Professor of Orthopaedic Surgery
Department of Orthopaedic Surgery
Keck School of Medicine
University of Southern California
nswolfso@usc.edu
(323) 226-7346 phone
http://www.usc.edu/medicine/orthopaedic_surgery

----- Original Message -----
From: alexander chelnokov <alex61@gmail.com>
Date: Monday, August 6, 2007 9:14 am
Subject: [ORT-L] Proximal tibia fracture
To: ORT-L@www2.aaos.org

> Dear colleagues
>
> Pls advise on management of proximal tibia injury in a 27 y.o. male
> 2 weeks after RTA. Images attached. What approach and what fixation
> would be your choice?
>
> --
> Best regards,
> Alexander N. Chelnokov
> Ural Scientific Research Institute
> of Traumatology and Orthopaedics
> 7, Bankovsky str. Ekaterinburg 620014 Russia
---
[This E-mail scanned for viruses by Declude Virus]

wdburman at frontiernet
New User

Aug 6, 2007, 11:47 AM

Post #4 of 7 (3518 views)
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Re: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

>>Approach: posteromedial

For the posteromedial proximal tibial approach see Robert Probe's OTA
BFC Lecture:
http://www.hwbf.org/ota/bfc/probe/ft004.html
and OTA List archive:
http://www.hwbf.org/hwb/conf/mess3/plat.htm

Bill Burman, MD
HWB Foundation
http://www.hwbf.org

>Dear Alex:
>
>Thanks for sharing this case.
>Based on the images ( it would be nice to have axial cuts),it seems
>to be posteromedial fragment, almost all the way into posterior
>portion of the tibial eminance.
>
>Approach: posteromedial, but you have to open the joint, since the
>fragment is small and there will be an issue with the medial
>meniscus ( likely torn).
>
>The appearance of the fragment is indicative of a shearing injury,
>so you will need small screws ( hand set ) that will have to be
>subchondral, or, start from the back and transfix the fragment going
>into anteroinferior direction. MRI might be sometimes useful to
>assess integrity of the ligaments. I hope there is no vascular
>issues.
>
>Good luck.
>
>Nikolaj
>
>Nikolaj Wolfson, MD, FRCSC
>Assistant Professor of Orthopaedic Surgery
>Department of Orthopaedic Surgery
>Keck School of Medicine
>University of Southern California
>nswolfso@usc.edu
>(323) 226-7346 phone
>http://www.usc.edu/medicine/orthopaedic_surgery
>
>
>----- Original Message -----
>From: alexander chelnokov <alex61@gmail.com>
>Date: Monday, August 6, 2007 9:14 am
>Subject: [ORT-L] Proximal tibia fracture
>To: ORT-L@www2.aaos.org
>
>> Dear colleagues
>>
>> Pls advise on management of proximal tibia injury in a 27 y.o. male
>> 2 weeks after RTA. Images attached. What approach and what fixation
>> would be your choice?
>>
>> --
>> Best regards,
>> Alexander N. Chelnokov
>> Ural Scientific Research Institute
>> of Traumatology and Orthopaedics
>> 7, Bankovsky str. Ekaterinburg 620014 Russia
>---
>[This E-mail scanned for viruses by Declude Virus]
---
[This E-mail scanned for viruses by Declude Virus]

bev at 3dmedicalconcepts
New User

Aug 6, 2007, 2:33 PM

Post #5 of 7 (3518 views)
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RE: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

I am sorry, but we are not Orthopedic Surgeons, we only manufacture
orthopedic instruments. I am affraid we are not much help in this matter.
You will probably need to seek assistance from a qualified orthopedic
surgeon. Good Luck!

collaborating to create surgical solutions

Beverly L. Laird, Ph.D.
3D Medical Concepts, LLC
1061 Morgan Park Road
Pelham, AL 35124
205-987-0935
205-987-0936 (fax)
www.3dmedicalconcepts.com <http://www.3dmedicalconcepts.com>

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org]On
Behalf Of alexander chelnokov
Sent: Monday, August 06, 2007 11:16 AM
To: ORT-L@www2.aaos.org
Subject: [ORT-L] Proximal tibia fracture

Dear colleagues

Pls advise on management of proximal tibia injury in a 27 y.o. male
2 weeks after RTA. Images attached. What approach and what fixation
would be your choice?

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

---
[This E-mail scanned for viruses by Declude Virus]

dpzamorano at hotmail
New User

Aug 6, 2007, 4:38 PM

Post #6 of 7 (3518 views)
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RE: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

I like the posteriormedial approach in the prone position. Interval is
between the medial head of gastrocs and semimembranosus

dave

_______________________________________________

David P. Zamorano, MD
UCI Dept. of Orthopaedic Surgery
Director, Orthopaedic Trauma
(714) 456-5582 office
dzamoran@uci.edu

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On Behalf
Of alexander chelnokov
Sent: Monday, August 06, 2007 9:16 AM
To: ORT-L@www2.aaos.org
Subject: [ORT-L] Proximal tibia fracture

Dear colleagues

Pls advise on management of proximal tibia injury in a 27 y.o. male
2 weeks after RTA. Images attached. What approach and what fixation would be
your choice?

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

---
[This E-mail scanned for viruses by Declude Virus]

mangalparihar at gmail
New User

Aug 7, 2007, 11:34 AM

Post #7 of 7 (3509 views)
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RE: [ORT-L] Proximal tibia fracture [In reply to]	Can't Post

Dear Alex,

What is this?

A PCL avulsion with a broad area of articular surface?

Mangal Parihar
Orthopedic Surgeon, Mumbai

-----Original Message-----
From: ORT-L-owner@www2.aaos.org [mailto:ORT-L-owner@www2.aaos.org] On Behalf
Of alexander chelnokov
Sent: 06 August 2007 21:46
To: ORT-L@www2.aaos.org
Subject: [ORT-L] Proximal tibia fracture

Dear colleagues

Pls advise on management of proximal tibia injury in a 27 y.o. male
2 weeks after RTA. Images attached. What approach and what fixation would be
your choice?

--
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia

---
[This E-mail scanned for viruses by Declude Virus]

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