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FRACTURE OF THE TIBIAL PLATEAU SCHATZKER V AND SOFT TISSUE NECROSIS OF THE DISTAL TIBIA IN A PATIENT WITH UNCONTROLLED DIABETES – CASE REPORT

Authors

  • Valentin Vejseli University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Andreja Gavrilovski University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Hristijan Kostov University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Ana Kaftandzieva Institute of Microbiology and Parasitology, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Aleksandra Gavrilovska Dimovska University Clinic for Neurosurgery, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Hristijan Bozhinovski University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Aleksandar Trajanovski University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Teodora Todorova University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
  • Simon Trpeski University Clinic for TOARILUC, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia

Keywords:

Tibial plateau fracture, Schatzker type V,, Compartment syndrome

Abstract

Tibial plateau fractures or proximal tibial fractures occur mostly due to car accidents, fall from a height or during sports activities. Usually these are injuries sustained due to a great force, and because of the proximity of the bone tissue to the skin they are often accompanied by a significant damage of the surrounding soft tissue. Having in mind the injuries of the soft tissue, an appropriate definitive plan is important. Certain plans need to be focused on the presence of blisters, open injuries and compartment syndrome.

We present a case of a 57-year-old patient who was admitted to the University Clinic for Traumatology due to a lower leg fracture as a result of high-energy trauma. The patient was injured in a car accident and suffered a platotibial fracture of the right leg according to the Schatzcker classification type V, and a patellar fracture without dislocation.

Despite the successful surgical treatment, the patient developed infection distal of the operated area, after which a necrosis of the soft tissues ensued, followed by a compartment syndrome. This type of complication has been described in the literature. We cannot be certain about the origin of the infection, but the obesity and the uncontrolled diabetes are definitely increasing the risk of infection and delayed wound healing.

References

Barr JS. The treatment of fracture of the external tibial condyle. JAMA. 1940;115(20):1683.

Schatzker J, Mcbroom R, Bruce D. The Tibial Plateau Fracture: The Toronto Experience 1968-1975. Clin Orthop Related Res 1979; 138: 94-104..

Narayan B, Harris C, Nayagam S. Treatment of high-energy tibial plateau fractures. Strategies Trauma Limb Reconst 2006; 1(1): 18-28. doi: 10.1007/s11751-006-0002-4.

Waddell JP, Johnston DW, Neidre A. Fractures of the tibial plateau: A review of ninety-five patients and comparison of treatment methods. J Trauma 1981; 21(5): 376-381. doi: 10.1097/00005373-198105000-00007.

Burrows HJ. Fractures of the lateral condyle of the tibia. J Bone Joint Surg Br 1956; 38-B(3): 612-613. doi: 10.1302/0301-620X.38B3.612.

Rasmussen DS. Tibial condylar fractures, Impairment of knee joint stability as an indica-tion of surgical treatment. J Bone Joint Surg Am. 1973; 55(7): 1331-1350. PMID: 4586086.

Luo CF, Sun H, Zhang B, Zeng BF. Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 2010; 24(11): 683-692. doi: 10.1097/BOT.0b013e3181d436f3.

Zhang Y, Fan DG, Ma BA, Sun SG. Treatment of complicated tibial plateau fractures with dual plating via a 2-incision technique. Orthopedics 2012; 35(3): e359-e364. doi: 10.3928/01477447-20120222-27.

Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop 2013; 47(2): 188-194. doi: 10.4103/0019-5413.108915.

Neogi DS, Trikha V, Mishra KK, Bandekar SM, Yadav CS. Comparative study of single lateral locked plating versus double plating in type C bicondylar tibial plateau fractures. Indian J Orthop 2015; 49(2): 193-198. doi: 10.4103/0019-5413.152478.

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Published

2023-06-16

Versions

Issue

Vol. 3 No. 2 (2023): Acad Med J

Section

Case Reports