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KNEE PAIN

LOW RISK



This patient presents with knee pain, suspicious for . Able to flex and extend although somewhat limited by pain. Considered, but doubt, tibial plateau fracture, septic arthritis, other acute unstable fracture, or significant neurovascular compromise.



Plan: XR, pain control, reassessment



HI RISK – Tibial Plateau



This patient presents with knee pain suspicious for a tibial plateau fracture given history, exam, and mechanism. No e/o compartment syndrome, septic arthritis, other acute fracture. Range of motion is . Will get plain films, consider CT, likely ortho consultation, pain control, NWB.



PEARLS:



Knee EXTENSION is an extremely important motor finding to document. Inability to extend is a key indicator of serious pathology.

In peds, follow the medial tibial diaphysis up to the epiphysis – it should be smooth all the way. A bump should make you suspicious for a buckle fracture; it’s frequently missed by radiology.

Proximal fibular fractures are associated with a peroneal nerve injury (you should document its status)

Tibial plateau fractures are high risk for compartment syndrome.

Tibial spine fractures are a) associated with ACL tears and b) often missed unless you order a tunnel view plain film.



from natedotphrase.com













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