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Skiing tibial plateau fracture

Aktuelle Preise für Produkte vergleichen! Heute bestellen, versandkostenfrei One of the more devastating injuries we see coming off the ski hill is a fracture involving the knee joint, also known as a tibial plateau fracture. It's much more likely to be seen in skiers than in snowboarders, and almost always requires surgery Tibial Plateau Fracture. The medical centre confirmed that John had a tibial plateau fracture - a fracture of the lower part of the knee joint: One of the advantages of my job is that I knew who to call and sending X-rays by iPhone was simple. The advice back was to find a 'knee specialist' quickly and just get home While I was assiduous about rehab from a tibial plateau fracture I went to the USA with an unrealistic view of what a return to skiing would look like. What were the issues likely to be? What management plan should I follow? The simple answer was I had no plan. I simply went out and tried to ski This is what a program should look like, eight months and two days after tibial plateau fracture surgery. If you are younger than me, you may be leg pressing a lot more than 70 kg. If you are older or haven't been as regular with your exercises, you may be pressing a lot less. A typical exercise chart for 8 months post surgery

Xrays at the resort clearly showed a tibial plateau fracture in my right tibia. Fracture was about mid way on the plateau and split vertically down the tibia's shaft about 4-5″. Surgery was the 14th leaving me with 3 large screws through the plateau and a plate on the medial side of the tibia with 6 more screws I fractured my tibial plateau after my ski clipped a hard bank of snow on a narrow 'blue' path in Meribel. The edge of the bank was solid like a half pipe - I flipped over and my ski didn't release - my leg did a full 180 turn and twisted my knee so violently I felt the injury happening Tibial Plateau Fractures are one of the worst injuries you can incur as a skier. TGR Forums has a 77 page thread dedicated to this injury. It's totally blackpilling (makes you feel like there is no hope). I want to provide a better pill for those who have endured this injury The upper tibia is also prone to becoming fractured in high speed accidents such as those associated with skiing, horseback riding and certain water sports. Symptoms of a Tibial Plateau Fracture . A fracture of the upper tibia may result in injury to both the bone and the soft tissues of the knee region. The symptoms of a tibial plateau.

Type V, or a split bicondylar fracture, is a fracture of both the lateral and medial tibial plateau, usually with lateral depression. This high-energy trauma is frequently associated with meniscal detachment (seen in one half of patients) and ACL avulsions (seen in one-third of patients) Recovery from a Tibial Plateau fracture is different from person to person. It depends very much on the exact type and specifics of injury, your age, prior issues, level of physical activity, physiotherapy, nutrition and many other factors Tibial plateau fractures are uncommon in sports. Between 1977 and 1986, the authors studied 18 skiers who suffered tibial plateau fractures. Fracture patterns were diverse and displacement minimal. Hyperextension-valgus displacement caused compression fracture of the anterolateral tibial plateau in a characteristic form in 44%

Plateau -75% - Plateau im Angebot

US Ski Team Physician Bartlett White, PA-C Teaching Associate . REHABILITATION GUIDELINES FOR TIBIAL PLATEAU FRACTURE 2 | P a g e PHASE II (WEEKS 6-12) DATES: Appointments • MD follow up at week 6 • Continue physical therapy 2 x week. I see tibial plateau fractures fairly frequently here in ski country. Tibial plateau fractures are fractures involving the top of the tibia or shin bone. They can be serious injuries because they.. This study investigates fractures of the tibial plateau resulting from downhill skiing accidents over a 19-year period ending in 1991 at a moderate-sized ski area in northern Vermont. Thirty-nine skiers who suffered tibial plateau fractures were compared with other injured skiers who sustained 11 357 injuries and 2190 noninjured controls over.

Total skier visits equals 5 912 735, the total number of injuries equals 16 790; femur fractures equals 67, tibial plateau fractures equals 88. Femur fractures: There has been no significant change in MDBI (Mean Days Between Injury) for femur fractures Patients usually describe a sudden twisting type force to the knee while skiing and may also report hearing or feeling a pop and having swelling and pain. Tibial plateau fractures are fractures of the top part of the tibia or lower leg bone. The knee joint is made up of the bottom end of the femur gliding on the top part of the tibial plateau Tibial plateau fractures are typically caused by a strong force on the lower leg with the leg in varus or valgus position, or simultaneous vertical stress and flexion of the knee. Commonly seen in road traffic accidents, sports accidents with a high velocity such as skiing, horse riding, and certain water sports

Doctor's Note: A tibial plateau fracture will ruin your

  1. The upper surface of the tibia or shinbone is called the tibial plateau. If you engage in activities such as horse riding, skiing, and certain water sports, you are likely to get a tibial plateau fracture
  2. Patients usually describe a sudden twisting-type force to the knee while skiing and may also report hearing or feeling a pop, and having swelling and pain. Tibial plateau fractures are fractures of..
  3. g fractured in high-speed accidents such as those associated with skiing, horse riding, and certain water sports. Tibial plateau fracture symptoms There is normally a recent history of trauma to the knee
  4. Introduction: Tibial plateau fractures occur frequently during downhill skiing. There is a lack of information about the outcome and development of posttraumatic osteoarthritis after internal fixation of such fractures at long-term follow-up in skiers
  5. Tibial Plateau Fracture Recovery Blog Essential Items: Read about what essential items and products that helped me during my recovery here. In my internet travels, I've even seen people get back to their extreme sports such as triathlons, mountain climbing, skiing, and mountain biking

Case Study: Skiing after a Tibial Plateau Fracture - Ski Moj

  1. Tibial Plateau Fracture Rehab: Weeks 1-6: Your therapist will begin immediately with steps to reduce inflammation, calm pain, and begin to promote healing. The therapist focuses on maintaining knee extension and non-weight-bearing movement to promote healing and to prevent further pain and reinjury. Exercises might include active and passive.
  2. Tibial Plateau Fracture Surgery is required when the bone breaks into two or more fragments and surgery is normally needed. This fracture involves the proximal (upper) portion of the tibia which extends through the articular surface (into the knee joint). It is a serious type of knee injury that can affect all types of men and women athletes
  3. imal. Hyperexten sion-valgus displacement caused compression fracture of the anterolateral tibial plateau in a characteristic form in 44%
  4. The tibial plateau is one of the load bearing structures that holds most of the weight of the body, therefore if it is injured it can impact the lifestyle of the individual to a great extent. The following is a generalised guide to the fracture types, treatment and recovery and how they can occur

Tibial plateau fractures occur when a force drives the femur into the top of your tibia and cracks the bone. If the bone stays in place, the fracture is non-displaced. If bone fragments shift, the fracture is classified as displaced. In addition to being classified as either displaced or non-displaced, these injuries are also graded on the. A tibial plateau fracture is a break in the top of the shin bone (tibia). The top of the tibia has a flat, smooth surface (tibial plateau). This part of the tibia is softer than the rest of the bone. It forms the bottom of the knee joint. If a strong force shoves the thigh bone (femur) down and onto the tibial plateau, the tibial plateau can. Background Tibial plateau fractures (TPFs) are frequently associated with motor vehicle accidents, auto-pedestrian crashes and falls. However, hospitals near ski resorts commonly treat TPF resulting from skiing. The soft tissue envelope and original mechanism of injury are important determinants in the decision to proceed with immediate or delayed fixation of the fracture Skier Tibia (Leg) Fractures In years past, the prototypical ski fracture was sustained at the lower part of the outside of the leg in the region of the ankle. However, in the past 10 years, with the advent of the modern ski boots and improvements in binding, the most commonly seen lower leg skier fracture is the tibia (or shinbone) fracture.. If you engage in activities such as horse riding, skiing, and certain water sports, you are likely to get a tibial plateau fracture. Since the tibial plateau contains certain structures essential for proper functioning of your knees, a fracture to this area may lead to some serious consequences. Fractures of the tibial plateau are usually.

Tibial Plateau Fractures: Evaluation, Assessment and Treatment Thuan V. Ly, MD Ohio State University. Objectives •Recognize the anatomy of the proximal tibia •Describe initial evaluation and management •Identify common fracture patterns •Apply treatment principles and strategie Tibial plateau fractures are usually classified with the six-type Schatzker fracture classification. 13 The AO/OTA 14 proximal tibia fracture classification (segment 41) is partially based on it, and includes extra-articular (a), partial articular (b) and complete articular (c) fractures. Schatzker Type I-II-III-IV should correspond to 41B.

A skiing plan following tpf surgery - Tibial Plateau Fractur

  1. imum follow-up of 24 months. The sporting activity was deter
  2. If you've recently suffered a Tibial plateau Fracture this is the place for you. This site was created after having myself gone through the recovery process of Tibial Plateau Fractures, and this site aims to contain information you need and want to know during Recovery. You can visit the forum to chat and share your story with others
  3. Welcome to my continuing journey of my tibial plateau fracture recovery. Tibial Plateau Fracture Recovery Update: Moving on with life after a tibial plateau fracture: My first post of the new year. Happy 2018 everyone! I'm glad I decided to journal my tibial plateau fracture recovery. I hope that it is helping those of you reading this in.
  4. A tibial plateau fracture is a bone fracture or break in the continuity of the bone occurring in the proximal part of the tibiaor shinbone called the tibial plateau; affecting the knee joint.

Tibial Plateau Fractures. - Discussion: - 60% of plataue frxs involve lateral plateau. - this probably is result of valgus alignment of lower extremity and fact that most injuring forces are. directed laterally to medially; - frxs of medial plateau make up 15% & bicondylar lesions 25% of plateau frx; - bicondylar frxs combine any of unicondylar. A tibial plateau fracture is an injury in which you break your bone and injure the cartilage that covers the top end of your tibia (bottom part of your knee). The break can range from a single crack in your bone to shattering into many pieces. This fracture typically happens after a fall or a motor vehicle accident I had a Tibial Plateau Fracture last ski season (Christmas Day). I had no idea it would take so long to recover. I still am not back to normal activity. My fracture was right medial and I have a plate and 6 screws. I was non weight bearing for 3 months and gradually started bearing weight after that A tibial plateau fracture is a break of the larger lower leg bone below the knee that breaks into the knee joint itself. It is rare to only just break the bone. This is an injury that can involve the bone, meniscus, ligaments, muscles, tendons and skin around the knee. All of these structures must be taken into account when diagnosing and. Long story short, tibial plateau fracture, type 5 on their weird scale of 1-6, major trauma says the surgeons and doctors. Overall, not a fun experience, but I'm at the tail end and it feels damn good. It's absolutely insane how your entire life can change in a second. 41 years young, lots more time to explore

Skiing exercises begin - Tibial Plateau Fractur

Tibial Plateau Fracture - Skiing Orthope

  1. A: I see tibial plateau fractures fairly frequently here in ski country. Tibial plateau fractures are fractures involving the top of the tibia or shin bone. They can be serious injuries because they entail disruption of not only bone but also disruption of the coating or articular cartilage on the top of the tibia
  2. g fractured in high speed accidents such as those associated with skiing, horse riding and certain water sports. Tibial plateau fracture symptom
  3. The tibia, or shinbone, is the most commonly fractured long bone in the body. A tibial shaft fracture occurs along the length of the bone, below the knee and above the ankle. It typically takes a major force to cause this type of broken leg. Motor vehicle collisions, for example, are a common cause of tibial shaft fractures

Skiing after a tibial plateau fracture, snowHeads ski foru

Tibial Plateau Fracture. A fracture, or break, in the upper part of the shinbone (tibia) may result from a low-energy injury, such as a fall from a height, or from a high-energy injury, such as a motor vehicle accident.Proper identification and management of these injuries will help to restore limb function (strength, motion, and stability) and reduce the risk of arthritis Tibial plateau fractures were originally termed a bumper or fender fracture but only 25% of tibial plateau fractures result from impact with automobile bumpers. Pathology The most common mechanism of injury involves axial loading, e.g. fall fro..

https://www.thekneepainguru.com/ - Tibial Plateau Fracture with Challenges Walking. The question I address in this presentation comes up as I learn about the.. The posterior shearing tibial plateau fracture: treatment and results via a posterior approach. Medial buttress versus lateral locked plating in a cadaver medial tibial plateau fracture model . Staged management of high-energy proximal tibia fractures (OTA types 41): the results of a prospective, standardized protocol

Tibial plateau fracture - Wikipedia

Tibial Plateau Fracture SkiTalk Ski reviews, Ski Selecto

  1. ology to accurately.
  2. A tibial stress fracture is a hairline fracture of the tibia bone in the lower leg caused by overuse or repetitive stress. Symptoms are very similar to 'shin splints' with gradual onset pain on the inside of the shin. Here we explain the symptoms, causes, and treatment for a stress fracture of the tibia..
  3. Six more weeks | Tibial Plateau Fracture | Toronto. Thursday, February 22, 2018. This is a departure from my regular photography posts, but I thought many of you would like an update on my progress. It's kind of long - I have found that there isn't a lot out there about recovering from a tibial plateau fracture so maybe this post will be.
  4. Tibial plateau fractures occur frequently during downhill skiing. There is a lack of information about the outcome and development of posttraumatic osteoarthritis after internal fixation of such fractures at long-term follow-up in skiers. A population of 83 skiers was followed up in a case series after internal fixation of intra-articular tibial plateau fractures AO-OTA 41 B1-B3 and C1-C3

Tibial Plateau Fracture Causes, Symptoms and Treatmen

Like a mountain with a flat top, this flat surface is called the Tibial Plateau. This is a very sturdy surface, yet it is vulnerable to trauma and can break (fracture). The most common injuries result from a side blow to the knee. This can occur in sports, like skiing and football, or from trauma, like a fall or a car accident A broken tibia-fibula is a fracture in the lower leg that happens when a fall or blow places more pressure on the bones than they can withstand. A tibia-fibula fracture is a serious injury that requires prompt immediate medical attention. With timely and proper treatment, a broken tibia-fibula can heal completely Tibial plateau fractures are common in downhill skiing and their frequency has increased considerably over the past 15 years [1,2,3].The reasons for this rise are numerous and can be explained by an increase in boot height, poor adjustment of fixtures, poor snow conditions—especially alternating episodes of ice and wet snow—speed and often the skiers' lack of experience Tibial plateau fractures can have subtle radiographic findings. Maintain a high clinical suspicion for obtaining additional imaging or CT for patients unable to bear weight in the ED following injury. Evaluate patients with high-energy mechanisms of injury for compartment syndrome and consider observation for serial examinations TIBIAL PLATEAU • Tibial plateau is the proximal end of tibia including metaphyseal, epiphyseal regions as well as articular surfaces. • AO defines tibial plateau as metaphysis to a distance equal to the width of the tibia at the joint line. 3. EPIDEMIOLOGY • Tibial plateau fractures constitute 1% of all fractures and 8% of all fractures.

Tibial fractures occur in both high energy trauma, such as motor vehicle, winter sports (eg, skiing), and cycling accidents, and low energy trauma, such as falls, contact sports, distance running, and other endurance or repetitive impact activities. Injuries caused by high energy trauma are more likely to involve complex and open tibia. Tibial plateau depression is measured as the vertical distance between the lowest point on the intact medial plateau and the lowest depressed lateral plateau fracture fragment. Schatzker et al ( , 2 ) originally defined depression as measuring greater than 4 mm Most tibial plateau fractures are a result of trauma to the leg, such as: a fall from height; a motor vehicle accident; injuries from sports such as football or skiing They occur in a bimodal distribution, with high energy fractures occurring in the young secondary to falls from heights, car bumper injuries, and strong valgus or varus forces as occur in football games or skiing, and a second peak in the elderly from low energy, relatively minor valgus forces causing lateral injuries. 55-70% of tibial plateau. A tibial plateau fracture is a crack or break on the top surface of the tibia or shinbone in the knee joint. The fracture most often occurs following a high-intensity trauma or injury from the impaction of the femoral condyles over the tibial plateau. Fractures of the tibial plateau are serious injuries that are more commonly seen in athletes.

Medial Tibial Plateau Fracture. Varus blow to medial aspect of knee directed laterally. Less common than lateral Tibial Plateau Fracture (requires greater force to cause Fracture) Fall from height with axial compression. Twisting injury in Osteoporosis. ACL Tear. Associated intercondylar eminence Fracture. III A tibial plateau fracture is a break of the upper part of the tibia (shinbone) that involves the knee joint. Symptoms include pain, swelling, and a decreased ability to move the knee. People are generally unable to walk. Complication may include injury to the artery or nerve, arthritis, and compartment syndrome. The cause is typically trauma such as a fall or motor vehicle collision Depending on when you were operated you will require a minimum of 3 -4 months to heal. Your orthopedic surgeon and physiotherapist will in these 3 months train you with isometric active and passive knee exercises to gain strength and range of moti.. Abstract. Tibial plateau fracture is a rare complication of unicompartmental knee arthroplasty. The fracture almost always occurs during surgery, and it is likely to be the result of a technical.

Medical conditions similar to or like. Tibial plateau fracture. Break of the upper part of the tibia that involves the knee joint. Wikipedia. Knee dislocation. Knee injury in which there is a complete disruption of the joint between the tibia and the femur. Symptoms include knee pain and instability of the knee Non-Displaced Tibial Plateau Fractures Most non-displaced fractures of the tibial plateau can be treated without surgery, but they usually require an extended period (up to 3 months) of protection from walking. If displacement occurs, surgery may be needed to realign the bone fragments and hold them in position A tibial plateau fracture is the same injury that caused Houston Texans star J.J. Watt to miss the final three months of the 2017 season. Rodgers called the injury very painful, which given.

Introduction. Tibial plateau fractures occur commonly during winter activities and injuries to the knee represent about 20-36% of all skiing injuries in adults , .Medial Moore type I and II injuries are fairly rare injuries characterised by a dorso-medial main fracture fragment , .The Orthopaedic Trauma Association (AO/OTA) or the Schatzker et al. , , , , classification systems can be used. The fracture patterns between snowboarding and skiing were different; the most common fracture type in skiers was spiral tibial shaft fracture compared to proximal tibial fractures in snowboarders These injuries from high-energy sports include football, skiing, and rugby usually occur in young adults with good bone quality. Tibial plateau fractures can also occur in basketball, volleyball, or lacrosse. Low-energy forces can cause a tibial plateau fracture usually in older patients with poor bone quality Tibial_Plateau_Fractures_-_Initial_Management_Guidelines Author: M & B Lawson Created Date: 1/28/2013 3:47:37 PM. Tibial Plateau fractures involve the proximal articular surface of the tibia. These fractures can vary from mild displacement to severe comminution and are commonly associated with soft tissue injuries. Patients age, bone quality and mechanism of injury are a few important variables that play a role in the severity of the injury

Recovery - Tibial Plateau Fracture - tibial plateau fracture

Tibial plateau fractures in alpine skiing - PubMe

The tibia is the most commonly fractured long bone. In broad terms, fractures may be divided into those affecting the proximal tibial articular surface (tibial plateau fractures), extra-articular fractures of the shaft, and those affecting the distal articular surface (pilon fractures). Of note, the latter are distinct to ankle fractures, which. Tibial Plateau Fracture Post-Operative Protocol Phase I - Maximum Protection (0 to 1 weeks): O to 1 week: Ice and modalities to reduce pain and inflammation Use crutches non-weight bearing for 6 weeks Brace for 6 weeks in full extension Elevate the knee above the heart for the first 3 to 5 day These fractures are tibial plateau fractures, or intra-articular fractures. When a strong force drives the femur, or the lower part of the thighbone, into the tibial plateau's softer bone, it often results in a tibial fracture. Tibial plateau fractures affect the joint of the knee, consequently altering motion and stability

Why skiing breaks our legsTibial fracture location with related mechanism of injuryHow to Exercise With a Broken Tibia & Fibula | Broken

Tibial plateau fractures can be serious injuries

Tibial Plateau Fracture The upper end of the shin bone (tibia) is known as the plateau. It is relatively flat, and makes up the lower end of the knee joint. Injuries to the tibial plateau are usually caused by a large amount of weight being forced through the leg such as falls and car crashes Tibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture. 39 consecutive patients (ages 20-61 years) were.

Tibia fractures can also be closed or open. With closed fractures, the bone doesn't break through the skin. Internal soft tissues such as tendons and blood vessels may be affected by this type. The upper surface of the tibia (shin bone) is the tibial plateau. This tibial plateau is highly susceptible to fracture in accidents involving high speed e.g. skiing, horse riding and some water sports. Know what is Fractured Tibial Plateau or Tibial Plateau Fracture, its classifications, causes, symptoms, etiology, and epidemiology Lateral depressed tibial plateau fracture in a polytrauma patient. An external fixator has been applied during the early resuscitative phase. This allows for CT scanning with the knee in normal alignment. Although the femoral condyle is no longer applying pressure to the lateral tibial plateau, the fracture is still depressed Tibial plateau fractures are intra-articular fractures that show extension of the fracture line into the joint surface of the proximal tibia. They can exist in isolation or be accompanied by other injuries either to local structures of the knee or elsewhere on the patient

Knee Injuries|Dislocated|Contusion|Sprain|Synovitis

Tibial Plateau Fractures in Downhill Skiin

A closed tibial plateau fracture is one where the bone doesn't break through the skin. If you have a tibial plateau fracture and an injury of the meniscus and/or cruciate ligament, this increases the full value of the pain and suffering component. Surgery on a Tibial Plateau Fracture. Some tibial plateau fractures can be treated without surgery Tibial plateau fractures involve the articular surface and adjacent metaphysis of the proximal tibia. Tibial plateau fractures accounted for 1.2% of the fractures treated in Edinburgh's population of more than 500,000 during the year 2000, ranking 16th of the 27 reported anatomic fracture locations. This is approximately the same frequency as. Tibial plateau fractures comprise 1% of all fractures. The incidence of tibial plateau fractures is 10.3 per 100,000 people annually [2]. The mean age of patients incurring tibial plateau fractures is 52.6 years. [2] The distribution of tibial plateau fractures is bimodal, with men under the age of 50 more likely to sustain this injury via high. Lessons: The incidence of tibial plateau fractures (TPF) related to UKA might be low, but fatal and difficult to treat. Its pathogenesis determines procedure-related factors; when fracture develops, treatment should be based on the degree of displacement, stability of implant fixation, etc A tibial plateau fracture occurs at the top of the shin bone and involves the cartilage surface of the knee joint. Because these fractures occur around the knee joint, they must be treated differently than tibial shaft fractures . When a fracture occurs into or around a joint surface, that joint is at high risk of developing arthritis due to.

Femur and Tibial Plateau Fractures in Alpine Skiin

Schatzker classification of tibial plateau fractures. The Schatzker classification system divides tibial plateau fractures into six types. First described 1979 by Canadian surgeon Joseph Schatzker. ZACHARIA JOSEPH and MIKE CADOGAN. October 15, 2018 Tibial Plateau Fracture. Include tunnel view (notch view) and consider oblique views (with knee internal/external rotation) Indicated in patients unable to bear weight but with negative or nondiagnostic XRay. Used in preoperative evaluation, with depression width and depth determining management Tibial plateau fractures (TPFs) are relatively common, accounting for approximately 1% of all fractures, and the population-based incidence of TPFs has been reported as 10.3-13.3 per 100,000 people annually [1, 2].Cases of TPFs were most common between the ages of 30 years and 60 years [3, 4].However, with improved life expectancy, incidences of TPFs in elderly patients are probably rising.

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Tibial plateau fractures were originally termed a bumper or fender fracture but only 25% of tibial plateau fractures result from impact with automobile bumpers. The tibial plateau is one of the most critical loadbearing areas in the human body; tibial plateau fractures affect knee alignment, stability, and motion Tibial Shaft Fractures Mechanism of Injury Can occur in lower energy, torsion type injury (e.g., skiing) More common with higher energy direct force (e.g., car bumper) Open fractures of the tibia are more common than in any other long bon Tibial plateau fractures can be very subtle and lipohaemarthrosis may be the only visible sign; Standard views. Anterior-Posterior (AP) and Lateral. In the context of trauma the Lateral view is acquired with the patient lying supine and with a horizontal X-ray beam. This allows effusions to be visualised in the suprapatellar pouch Background: Tibia plateau fractures are most commonly managed with open reduction and internal fixation (ORIF) technique, external fixation via minimally invasive technique are an excellent alternative. The aim of this study was to assess the results of tibia plateau fractures by using the Ilizarov external fixator. The analysis was done both clinically and radiologically Trust me, tibial plateau fractures are not 'minor'; your tibial plateau is the major structural component of your knee joint, and any irregularity or subsequent deformation could lead to a whole. Effectiveness of the management of bony articular collapse with bony defects in tibial plateau fractures with the use of genex: An absorbable calcium composite synthetic bone graft Lowery, K., et al. Journal of Limb Lengthening & Reconstruction 2018, 4(1): 20-25