Tibia proximal metaepiphysis bicondylar fracture

History of present complaint

57-year-old female patient, domestic injury, fall on the stairs, urgent hospitalization, surgical intervention on the second day after the injury, total follow-up period after surgery - 20 months, walking without additional support, lower limb full weight bearing, knee ROM 0/0/100 degrees, has no pain or complaints

Past medical history

Non relevant

Drug history, allergies

None

Social, family history

Non-smoker, no alcohol use

Physical exam

At the time of hospitalization: edema, hematoma in the u/3 area of the left leg, pathological painful mobility, crepitation of bone fragments, pathological valgus deformity, no active ROM

Investigations

X-ray, CT, ultrasound of the lower extremities vessels

Diagnosis

Tibia proximal metaepiphysis bicondylar fracture, type V Shazker

Treatment

Surgical treatment for urgent indications: fragments open reposition from two approaches, Cal-Cemex tibial articular defect substitute, osteosynthesis with 2 condylar plates, active rehabilitation from the day 1 postOp,  knee active ROM with a mechanical splint, limb full weight bearing 3 weeks postOp

Discussion

Follow-up after surgery - 20 months, full functional activity, no pain, walking without additional support, full weight bearing, knee ROM 0/0/100 degrees, high patient satisfaction.
The key point of the surgery is the use of Cal-Cemex bioactive ceramics, which ensured:

• p/o period without complications
• knee ROM from the day 1 after surgery
• full weight bearing 3 weeks postOp
• biological reconstruction of bone and joint defect
• tibia proximal metaepiphysis anatomical reconstruction
• Cal-Cemex: load-resistant material, innovative reinforced bone substitute, ß-TCP (ß-tricalcium phosphate) + PMMA (polymethyl methacrylate) - osseointegration + high mechanical strength