The Orthobullets Podcast Foundations⎪Trauma⎪Proximal Third Tibia Fracture
Jul 24, 2025
Explore the intricacies of proximal third tibia fractures in this engaging discussion. Delve into the anatomy, clinical presentation, and imaging techniques essential for accurate diagnosis. The podcast also covers various treatment options, ensuring that frontline providers are well-equipped for advanced clinical scenarios. Essential listening for anyone in the MSK field!
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Common Malunions in Fractures
- Proximal third tibia fractures commonly result in valgus and procurvatum malunions due to specific deforming muscle forces.
- Diagnosis relies on orthogonal tibial radiographs with CT often needed to check for intraarticular extension.
Muscle Forces Cause Deformities
- The patellar tendon causes the proximal fragment to extend leading to apex anterior deformity.
- The pes anserinus pulls the proximal fragment into varus, while anterior compartment muscles apply a valgus force.
Treatment Options by Fracture Severity
- Use closed reduction and casting for low-energy closed fractures with acceptable alignment.
- Operative treatment includes external fixation for soft tissue compromise and intramedullary nailing if there is adequate proximal bone for locking screws.