[Fracture of the tibial head]

Fractures of the tibial head are marked by huge variety. They can be classified into fractures of the tibial plateau, luxation fractures, and comminuted fractures. Luxation fractures are commonly associated with lesions of the menisci and intra- and extra-articular ligaments. Several factors may be responsible for the development of post-traumatic OA: anatomically nonreduced joint surface, malalignment, and unaddressed associated injuries. Therefore a sophisticated therapeutic regime is necessary. In case of severely damaged soft tissue or unstable patients, the fracture should first be reduced and fixed with an external fixateur and the osteosynthesis should be performed in a second setting. Arthroscopically assisted reduction and osteosynthesis are indicated for fractures of the tibial eminence, crack fractures, and impression fractures. Comminuted fractures can be addressed via several different incisions. Due to locking plates, the bilateral use of large plates can be avoided. In specific cases such as compound fractures and for patients with low compliance, hybrid fixateurs may be an alternative.