Overview
What is tibia and fibula fracture?
What are complications of tibia and fibula fracture?
What is included in the initial care of tibia and fibula fracture in the emergency department (ED)?
How are tibia and fibula fracture classified?
What is the prevalence of tibia and fibula fracture?
Presentation
Which clinical history is characteristic of tibia and fibula fracture?
What are the types of tibia and fibula fracture?
What is included in the physical exam for tibia and fibula fracture?
Which physical findings are characteristic of tibia and fibula fracture?
What are the complications of tibia and fibula fracture?
DDX
What are the differential diagnoses for Tibia and Fibula Fracture in the ED?
Workup
Which radiographic findings suggest stress fracture of the tibia and fibula?
Treatment
What is the included in prehospital care for tibia and fibula fracture?
What is compartment syndrome resulting from tibia and fibula fracture and how is it managed?
What is included in emergency department (ED) care for tibial plateau fracture?
What is included in emergency department (ED) care for tibial eminence fracture?
What is included in emergency department (ED) care for tibial tubercle fracture?
What is included in emergency department (ED) care for proximal tibia fractures?
What is included in emergency department (ED) care for tibia and fibula stress fractures?
Which medical personnel provide consultation to patients with tibia and fibula fracture?
Medications
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Shown is an intra-articular fracture of the medial condyle of the tibial plateau.
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Standard anteroposterior radiograph of a tibial shaft fracture with intramedullary nail fixation. Note the commonly associated fibular fracture that is also apparent.
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Radiograph demonstrating a displaced tibial shaft fracture with associated fibula fracture.
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Type II tibial plateau fracture in a young active adult with good bone stock treated with percutaneous elevation and cannulated cancellous screw fixation without bone grafting.
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Type III tibial plateau fracture with central depression in an elderly person treated surgically using percutaneous elevation, bone grafting, and cancellous screw fixation.
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Tibial plateau fractures. Line drawings of Schatzker types I, II, and III tibial plateau fractures. Type I consists of a wedge fracture of the lateral tibial plateau, produced by low-force injuries. Type II combines the wedge fracture of the lateral plateau with depression of the lateral plateau. Type III fractures are classified as those with depression of the lateral plateau but no associated wedge fracture.
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Tibial plateau fractures. Line drawings of Schatzker types IV, V, and VI tibial plateau fractures. Type IV is similar to type I fracture, except that it involves the medial tibial plateau as opposed to the lateral plateau. Greater force is required to produce this type of injury. Type V fractures are termed bicondylar and demonstrate wedge fractures of both the medial and lateral tibial plateaus. Finally, type VI fractures consist of a type V fracture along with a fracture of the underlying diaphysis and/or metaphysis.
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Tibial plateau fractures. CT image through the tibial plateau shows a fracture of the posterior aspect of the lateral tibial plateau, which is the source of the lipohemarthrosis.
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Tibial plateau fractures. Axial CT image through the tibial shows a fracture through the lateral tibial plateau with slight diastasis between the fragments. This is a Schatzker II injury.
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Tibial plateau fractures. Coronal reformatted CT. This image demonstrates a bicondylar fracture of the tibial plateau along with a fracture of the tibial diaphysis, a Schatzker VI fracture. Note the articular incongruity.
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Classification of tibial tuberosity fractures.