Article viewed 58 times

26 Jul 2025
Add to Bookmarks


 

Right Open Tibial Shaft Fracture with Fibular Head Avulsion (PLC Equivalent)

Score and Comment on this Case

Select a Score out of 10, and add a comment in the field below

Respectfully consider international variabilty in surgical technique and implants when commenting.
Protected by reCAPTCHA - Privacy and Terms


Clinical Details

Clinical and radiological findings:  A 19-year-old male pedestrian was involved in a motor vehicle collision while under the influence of LSD, resulting in bilateral open tibial fractures classified as Gustilo-Anderson Type II. The patient presented with soft compartments and no vascular injury. On the right side, there was an avulsion fracture of the fibular head, considered a posterolateral corner (PLC) injury equivalent. MRI was performed to assess other ligamentous and meniscal injuries.

Preoperative Plan

Planning remarks:  The preoperative plan included addressing the open tibial fractures and the fibular head avulsion on the right side. The surgical approach for the right fibular head avulsion was planned through a lateral incision to access the posterolateral corner structures.

Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table with a bump under the ipsilateral hip to facilitate lateral exposure of the right knee.

Anatomical surgical approach:  A lateral approach to the knee was performed, with an incision made over the fibular head. Dissection proceeded through the fascia lata, taking care to protect the common peroneal nerve. The fibular head and associated posterolateral structures were exposed for fixation.

Operative remarks: 

The surgeon noted that the fibular head avulsion was stabilized to address the PLC equivalent injury. This stabilization was crucial for restoring knee stability. The decision to fix the fibular head avulsion was based on its role in PLC injuries, although alternative management strategies could be considered by others.

Postoperative protocol:   Postoperatively, the patient was placed in a hinged knee brace with restricted weight-bearing on the right side for 6 weeks. Range of motion exercises were initiated early, with progression to full weight-bearing as tolerated after 8 weeks.

Follow up:   Not specified.

Orthopaedic implants used:   Orthopaedic implants used included screws for fibular head fixation.

Search for Related Literature

Powered by OrthoSearch - The British Editorial Society of Bone & Joint Surgery


#

orthopaedic_trauma
  • United States , Seattle
  • Area of Specialty - General Trauma
  • Position - Specialist Consultant
#
Industry Sponsership

contact us for advertising opportunities


Peer Review Score

Average Score based on 0 reviews

Catalogue Index