Fractures of tibial shaft and tibial head in winter sports

Abstract

Injuries in alpine skiing often affect the lower extremities, in particular the knee joint and lower leg. In addition to conventional radiological diagnostics, CT and, in the case of fractures of the knee joint area, MRI also play an important role. In the case of tibial head fractures, especially if there has been adislocation mechanism, there is an increased risk of vascular and nerve injuries. Lower leg fractures are predestined for the development of acompartment syndrome. For these reasons, an exact survey of the vascular-nerve status and amonitoring of the soft tissues should be carried out. In the further therapy, whether conservative or surgical, the soft tissue situation must also be included in the planning. In the case of tibial head fractures in particular, the choice of the right approach is essential for agood result in surgical therapy. Angle-stable plate osteosynthesis and screw osteosynthesis play the most important role as osteosynthesis methods in the knee joint area. In the case of fractures in the shaft area, medullary nail osteosynthesis or angle-stable plate systems are primarily used. In the case of severely compromised soft tissue or unstable situations, it may be necessary to apply an external fixator first. The initiated therapy should enable functional follow-up treatment as early as possible. Good physical fitness, driving-specific training, but also good core stabilization have apreventative effect against injuries. In addition, the correct material coordination between ski boot, binding and ski is important for accident prevention.