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Proximal fibula
Tibial plateau
Osteochondral fracture
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Shearing or rotatory forces
directed at the articular surface
of a femoral condyle.
2 main types
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Exogenous
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May result in
Supracondylar #
Patella #
Fibular head #
Tibial plateau #
Osteochondral fracture
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Site
Type
Mechanism
Exogenous
Direct impact
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Medial condyle
Endogenous
Rotation & compression forces
Exogenous
Direct impact
Lateral condyle
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1. Rotation and compression
Endogenous
2. Patella dislocation or reduction
Avulsion fracture
Some signs of ligamentous injury
Bony fragments indicates
Ligament
Sign of injury
Cause
ACL
Avulsion of anterior tibial eminence
Avulsion of anterior cruciate ligament
PCL
Avulsion of posterior tibial eminence
Avulsion of tibial attachment of PCL
LCL
Avulsion of lateral epicondyle
Avulsion of lateral collateral ligament
QT
Avulsion of superior or inferior
patella pole
Quadriceps contraction causing
avulsion of distal quadriceps /
proximal patella tendon
Avulsion of tibial tuberosity
Quadriceps contraction causing
avulsion of distal patella tendon
avulsion of the lateral collateral
ligament
Supracondylar fracture
•
Varity of configurations
•
Angulated distal fragment
•
Resulted popliteal artery injury
•
Associated with # dislocation
of hip or tibial shaft
Tibial plateau fracture
A valgus force with
impaction on the plateau
Typically result from the bumper
of a car striking the knee
Lateral plateau ~ 75-80%
Patella fracture
Patella fracture
Caused by direct blow or
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Vertical
Transverse
Bipartite patella
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Normal variant
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Separated ossific fragment at the
Patella dislocation
• Patella glide out of the
patellofemoral groove
superolateral aspect of the patella
•
Confused with a fracture
• Lateral dislocation
• Skyline view can help
for diagnosis of subluxation
Case study 1: M/73 S/F
Knee dislocation
•
Rare
•
Associated with rupture of
multiple ligaments
•
Risk of popliteal artery and
peroneal nerve injury
Transverse fracture of L patella
Case study 2: F/80 S/F
Case study 3: F/13 S/F
Transverse fracture of L patella
Lateral dislocation of R patella
Case study 4: M/53 RTA victim
Case study 5: M/55 IOD
# L lateral tibial plateau
Comminuted fracture tibial
plateau of L knee with distal
extension to proximal half
shaft
Case study 6: M/54 RTA
Case study 7: F/72 S/F
Longitudinal # of L patella
R proximal tibia fracture
Case study 8: F/72 R knee pain, no injury
Osteolytic lesion over medial tibial plateau
OA knee with huge subchondral cyst
Case study 9: F/26 RTA 1 week ago
Fracture lateral tibial plateau of R knee
Case study 10: F/59 Pain, no trauma
No fracture seen. Degenerative changes noted
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¾ http://www.sportsinjuryclinic.net/sport-injuries/kneepain
¾ http://ms-jbjsbr.drupal-stage-msweb01.highwire.org/highwire/filestream/10965/field_
highwire_article_pdf/0/436.full-text.pdf
¾ http://www.eorthopod.com/content/adult-kneefractures-types