Executive Editor: Ernst Raaymakers, Joseph Schatzker, Rick Buckley

Authors: Matthias Hansen, Rodrigo Pesantez

Proximal tibia Extraarticular fracture, avulsion of tibial spine

back to skeleton

Glossary

Nonoperative treatment
Indication summary Skill Equipment
Undisplaced and stable fracture Basic surgical experience, no specialized skills Basic equipment only

Indications

  • Undisplaced or minimally displaced, and stable fracture
  • Patient who cannot tolerate surgery

Contraindication

  • Open injury

Advantage

  • No risks of surgery

If fracture displaces, surgery is indicated.

Lag screws
Indication summary Skill Equipment
Single large fragment without comminution, associated knee dislocation Some specialized surgical experience Basic equipment only

Indications 

  • Single large fragment without comminution
  • Displaced and/or unstable
  • Associated with knee dislocation

Contraindications

  • Serious soft-tissue complications
  • Several serious medical co-morbidities

Advantage

  • Early stable reconstruction of cruciate integrity

Disadvantage

  • Surgical risks
Tension band fixation
Indication summary Skill Equipment
Single small fragment without comminution, associated knee dislocation Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Indications

  • Small fragment/s or comminuted fracture too small for lag screw fixation
  • Displaced and/or unstable
  • Associated with knee dislocation

Contraindications

  • Serious soft-tissue complications
  • Several serious medical co-morbidities

Advantage

  • Early stable reconstruction of cruciate integrity

Disadvantage

  • Surgical risks
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v2.0 2010-05-15