Tibial plateau fracture medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The non operative management is in the form of above knee cast or hinge knee brace for | The non operative management is in the form of above knee [[Orthopedic cast|cast]] or hinge knee [[Brace (orthopaedic)|brace]] for undisplaced stable split [[Bone fracture|fractures]], [[Bone fracture|fractures]] in [[Old age|elderly]] or patients with [[osteoporosis]] and minimally displaced or depressed [[Bone fracture|fractures]]. | ||
==Non Operative Treatment== | ==Non Operative Treatment== | ||
The non operative management is in the form of above knee cast or hinge knee brace.<ref name="pmid26378267">{{cite journal| author=Molenaars RJ, Mellema JJ, Doornberg JN, Kloen P| title=Tibial Plateau Fracture Characteristics: Computed Tomography Mapping of Lateral, Medial, and Bicondylar Fractures. | journal=J Bone Joint Surg Am | year= 2015 | volume= 97 | issue= 18 | pages= 1512-20 | pmid=26378267 | doi=10.2106/JBJS.N.00866 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26378267 }} </ref><ref name="pmid30584002">{{cite journal| author=Le Baron M, Cermolacce M, Flecher X, Guillotin C, Bauer T, Ehlinger M et al.| title=Tibial plateau fracture management: ARIF versus ORIF - clinical and radiological comparison. | journal=Orthop Traumatol Surg Res | year= 2018 | volume= | issue= | pages= | pmid=30584002 | doi=10.1016/j.otsr.2018.10.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30584002 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref> | The non operative management is in the form of above knee [[Orthopedic cast|cast]] or hinge knee [[Brace (orthopaedic)|brace]].<ref name="pmid26378267">{{cite journal| author=Molenaars RJ, Mellema JJ, Doornberg JN, Kloen P| title=Tibial Plateau Fracture Characteristics: Computed Tomography Mapping of Lateral, Medial, and Bicondylar Fractures. | journal=J Bone Joint Surg Am | year= 2015 | volume= 97 | issue= 18 | pages= 1512-20 | pmid=26378267 | doi=10.2106/JBJS.N.00866 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26378267 }} </ref><ref name="pmid30584002">{{cite journal| author=Le Baron M, Cermolacce M, Flecher X, Guillotin C, Bauer T, Ehlinger M et al.| title=Tibial plateau fracture management: ARIF versus ORIF - clinical and radiological comparison. | journal=Orthop Traumatol Surg Res | year= 2018 | volume= | issue= | pages= | pmid=30584002 | doi=10.1016/j.otsr.2018.10.015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30584002 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref> | ||
===Hinged knee brace with partial weight bearing 8-12 weeks and passive Range of Motion=== | ===Hinged knee brace with partial weight bearing 8-12 weeks and passive Range of Motion=== | ||
'''Indications''' | '''Indications''' | ||
*Nondisplaced stable split fractures | *Nondisplaced stable split [[fractures]] | ||
*Minimally displaced or depressed fractures. | *Minimally displaced or depressed [[Bone fracture|fractures]]. | ||
*Submeniscal rim fractures. | *Submeniscal rim [[fractures]]. | ||
*Fractures in elderly or patients with osteoporosis. | *[[Fractures]] in [[elderly]] or patients with [[osteoporosis]]. | ||
'''Advantages''' | '''Advantages''' | ||
*It is a simple technique. | *It is a simple technique. | ||
*No surgical trauma or risk for sepsis. | *No surgical trauma or risk for [[sepsis]]. | ||
*Shorter hospital stay. | *Shorter hospital stay. | ||
*Early joint mobilization if functional cast brace is used and delayed weight-bearing | *Early [[joint]] mobilization if functional cast [[Brace (orthopaedic)|brace]] is used and delayed weight-bearing. | ||
'''Complications''' | '''Complications''' | ||
*Risk of displacement and need for surgery | *Risk of [[displacement]] and need for [[surgery]] | ||
*Prolonged immobilization | *Prolonged [[immobilization]] | ||
*Complications of recumbency such as: | *[[Complication (medicine)|Complications]] of recumbency such as: | ||
**Pulmonary embolism | **[[Pulmonary embolism]] | ||
**Phlebitis | **[[Phlebitis]] | ||
*Joint stiffness | *[[Joint stiffness]] | ||
*Instability | *[[Instability]] | ||
*Post-traumatic arthritis | *Post-traumatic [[arthritis]] | ||
==References== | ==References== | ||
Latest revision as of 16:30, 5 February 2019
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Tibial plateau fracture Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Tibial plateau fracture medical therapy On the Web |
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American Roentgen Ray Society Images of Tibial plateau fracture medical therapy |
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Risk calculators and risk factors for Tibial plateau fracture medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
The non operative management is in the form of above knee cast or hinge knee brace for undisplaced stable split fractures, fractures in elderly or patients with osteoporosis and minimally displaced or depressed fractures.
Non Operative Treatment
The non operative management is in the form of above knee cast or hinge knee brace.[1][2][3]
Hinged knee brace with partial weight bearing 8-12 weeks and passive Range of Motion
Indications
- Nondisplaced stable split fractures
- Minimally displaced or depressed fractures.
- Submeniscal rim fractures.
- Fractures in elderly or patients with osteoporosis.
Advantages
- It is a simple technique.
- No surgical trauma or risk for sepsis.
- Shorter hospital stay.
- Early joint mobilization if functional cast brace is used and delayed weight-bearing.
Complications
- Risk of displacement and need for surgery
- Prolonged immobilization
- Complications of recumbency such as:
- Joint stiffness
- Instability
- Post-traumatic arthritis
References
- ↑ Molenaars RJ, Mellema JJ, Doornberg JN, Kloen P (2015). "Tibial Plateau Fracture Characteristics: Computed Tomography Mapping of Lateral, Medial, and Bicondylar Fractures". J Bone Joint Surg Am. 97 (18): 1512–20. doi:10.2106/JBJS.N.00866. PMID 26378267.
- ↑ Le Baron M, Cermolacce M, Flecher X, Guillotin C, Bauer T, Ehlinger M; et al. (2018). "Tibial plateau fracture management: ARIF versus ORIF - clinical and radiological comparison". Orthop Traumatol Surg Res. doi:10.1016/j.otsr.2018.10.015. PMID 30584002.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.