Tibial plateau fracture differential diagnosis

Tibial plateau fracture Microchapters
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Differentiating Tibial plateau fracture from other Diseases
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

Tibial plateau fracture must be differentiated from wrist strain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear.

Differentiating Distal Radius Fracture from other Diseases

• Tibial plateau fracture must be differentiated from other diseases that wrist pain, restriction of movements, and deformity, such as wrist strain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear.

Diseases	Clinical manifestations						Para-clinical findings			Gold standard	Additional findings
	Symptoms			Physical examination
							Imaging
	Pain	Restriction of Movements	Deformity	Tenderness	Integrity of extensor mechanism	Distal Pulses	X-ray	CT scan	MRI
Tibial plateau fracture	+	+	+/-	+	+	+/-	Fracture fragment displacement Fracture fragment angulation	Accurate diagnosis of fracture pattern ans aids in classification Useful for preoperative surgical planning for patients with complex, multifragmentary fractures.	Useful in diagnosing occult fractures, ligamentous and soft tissue injuries	CT
Segond Fracture	+	+	-	+	+	+	Evidence of fracture on radiographs is usually seen	Evidence of fracture on CT scan is usually seen	Soft tissue swelling and tear of the anterior cruciate ligament (ACL) accompanying the fracture is seen	MRI	It is pathgnomic of ACL tear
Patella Fracture	+	+	+	+	-	+	Fracture fragment displacement Fracture fragment angulation	CT confirms the x-ray finding	Swelling and tear of the patellar tendon and the retinaculum may be seen Also helps to identify osteochondral fragments	X-ray	Inability to do straight leg raising test.
Tibial tuberosity avulsion fracture	+	+	+	+	-	+	Tuberosity avulsion and displacement is seen	CT confirms the x-ray finding	Helps to identify accompanying patellar tendon injury	X-ray	Inability to do straight leg raising test.
Patella dislocation
Knee Dislocation
Diseases	Pain	Restriction of Movements	Deformity	Tenderness	Integrity of extensor mechanism	Distal Pulses	X-ray	CT scan	MRI	Gold standard	Additional findings
Meniscus Injury
Ligament Injuries (ACL, PCL, MCL, LCL)
Quadriceps Tendon Rupture
Osgood - Schlatter Disease
Peripheral Vascular Injuries
Maisonneuve fracture