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Fracturile platoului tibial

Fracturile platoului tibial. Conf. Dr. M. Nicolescu. Etiologie. Accidente auto & moto (70%) Caderi banale Accidente de munca sau sport. Compresie laterala : Bistolfi-Hulten Watson-Jones. Compresie axiala+/-lateralizata. Mecanism. Classification en fonction du mécanisme.

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Fracturile platoului tibial

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  1. Fracturile platoului tibial Conf. Dr. M. Nicolescu

  2. Etiologie • Accidente auto & moto (70%) • Caderi banale • Accidente de munca sau sport

  3. Compresie laterala : Bistolfi-Hulten Watson-Jones Compresie axiala+/-lateralizata Mecanism

  4. Classification en fonction du mécanisme Compression axiale Fracture bitubérositaire Fr. spinotubérositaires externes et internes Compression latérale Fracture-séparation externe et interne Fracture tassement Fr mixtes

  5. Fractura unituberozitara externa (40-55%): separare / tasare / mixta Fractura unituberozitara interna (8-10%) Clasificare

  6. Fractures unitubérositaires

  7. Fractures unitubérositaires + ruptures ligamentaires

  8. Clasificare • Fractura spinotuberozitara (5-15%) :

  9. Fractures spino-tubérositaires

  10. Clasificare • Fractura bituberozitara (30%) : simpla : T,V,Y inversate complexa cominutiva

  11. Leziuni asociate • Fractura extremitatii superioare a peroneului • Leziunea nervului peronier comun • Fractura unicondiliana femurala • Leziuni meniscale • Leziuni ligamentare (ligamente incrucisate)

  12. Evolutie • Calus vicios, dezaxare • Laxitate ligamentara cronica • Redoare articulara • Gonartroza

  13. Tratament • Conservator : TMP Apley – de Mourgues

  14. Tratament • Conservator : TMP Apley – de Mourgues • Chirurgical : fractura separare : suruburi buloane fractura tasare : ridicare + grefa + surub fractura mixta : ridicare + grefa bulonaj +/- placa fixator extern reducere percutana + artroscopie

  15. Fractures-séparation

  16. Fractures séparation+enfoncements • Le traitement est chirurgical • Relever le plateau (fragments de spongieux avec le cartilage) • Étayer par une greffe osseuse en dessous (± des broches) • Faire une ostéosynthèse du fragment séparé avec des vis ou une plaque vissée • Mobilisation douce et précoce pour récupérer la flexion

  17. Fractures-enfoncements

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