Challenge of the Week / Trauma / 03.26.2021

In a patient with polytrauma who has a Schatzker type-6 tibial plateau fracture, damage control orthopaedic management of this fracture should include which of the following?

    • Open reduction and internal fixation
    • Immediate open reduction and internal fixation may compromise the patient’s overall outcome if performed before the patient is stabilized by placing the patient at risk for hypothermia, acidosis, and coagulopathy.


    • Intramedullary nailing
    • Intramedullary nailing, if needed, is considered definitive management and should be delayed in damage control orthopaedics. It is not the definitive treatment of choice for tibial plateau fractures.


    • No immobilization
    • Immobilization is needed to help stabilize the patient’s injuries, restoring alignment and stability until definitive management can take place


    • Knee-spanning external fixator
    • A knee-spanning external fixator to correct the fracture deformity and shortening until the patient is stabilized and definitive management can be performed.


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