A complexidade do quadrante póstero-lateral nas fraturas do planalto tibial: relato de um caso atípico e revisão da literatura

Abstract

Certain fracture patterns of the tibial plateau may represent an atypical knee dislocation or subluxation, whose diagnosis may not be obvious in the initial assessment, especially if the knee is reduced in imaging studies. The association between posterolateral fracture of the tibial plateau and injuries of the anterior cruciate ligament, medial collateral ligament, and lateral meniscus is relatively frequent. Some patients may present a rare pattern of joint depression in the posterolateral region of the tibial plateau, in association with the injury of the anterior cruciate ligament, which resembles an apple bite, which is why it was called "apple-bite-fracture". The aim of the present study is to describe an atypical knee dislocation, accompanied by an even rarer fracture pattern, in which an osteochondral fragment is detached by shear forces, understood as a variation of the "apple-bite" pattern, and treatment with osteotomy of the lateral femoral epicondyle.