basic fracture knowledge

1. FRACTURES AROUND THE
KNEE
DR KIRAN PATIL

2. THIS PRESENTATION IS INTENDED FOR
• Discussing adult knee bony trauma
• Excludes paediatric and geriatric population
• Excludes associated injuries
• Common and obvious injuries are stressed less.
• Excludes pure ligamentous and soft tissue injuries around the
knee.

3. GENARAL CONSIDERATIONS
ANATOMY APPEARS DIFFERENT IN
MULTIPLE PLANES

4. GENARAL CONSIDERATIONS
• Femoral side injuries heal well relatively but are painful.
• Femoral side injuries require careful observation to avoid
stiffness
• Tibilal side injuries are less painful hence heal without stiffness
.
• Tibial side healing is relatively poor ,hence bone grafting as
primary procedure should be considered whenever there is a
gap or depression.

6. CT IS MANDATORY FOR IA FRACTURES AND
DOUBTFUL INJURIES

7. X RAY

9. EASY WAY OF OBTAINING LAT VIEW

11. POSITIONING FOR X RAYS

12. MRI
• BONY AVULSION LIG INJURIES
• RULE OUT NEOPLASM
• TO RULE OUT INFECTION
• PATHOLOGICAL FRACTURES
• STRESS INJURIES

14. DISTAL FEMUR FRACTURE
• CONDYLE FRACTURES
• APPROACH A;UNIVERSAL MIDLINE B;DEPENDING ON FRACTURE

22. TECHNICAL CONSIDERATIONS

23. MEDIAL CONDYLE IS MORE DISTAL THAN
LATERAL CONDYLE

24. LATERAL CONDYLE IS MORE ANTERIOR
THAN MEDIAL CONDYLE

25. PROXIMAL TIBIA FRACTURE

26. SEAGONDS FRACTURE
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28. REVERSE SEAGONDS FRACTURE

40. ANTERIOR INJURIES

41. POSTERIOR INJURIES

43. PATELLA
• Don‘t just concentrate on bone

46. AXIAL VIEW IMPORTANT

49. PROXIMAL FIBULAR FRACTURE
• Treatment of these fractures is dictated by the associated ligamentous or
neurovascular injury. Most injuries may be treated symptomatically in a
hinged knee brace and appropriate pain control. Early knee motion should
be encouraged.
• The proximal fibula fracture in a Maisonneuve injury does not require
stabilization. However, the intraossesous and/or syndesmotic injury may
require fixation near the ankle if the distal tibiofilular joint is unstable.
Closed reduction and casting is an additional treatment option.
• Open reduction and internal fixation may be indicated acutely for boney
avulsions of the LCL. Repair of associated posterolateral corner injuires to
the knee can be stabilized at the same time

53. TIBIAL EMINENCE FRACTURE