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Bumper fracture

*A bumper fracture is a compression fracture of the lateral tibial condyle due to a forceful valgus stress applied to the knee.

*The name is derived from the fact that a car bumper hitting the lateral aspect of the knee when the leg is firmly planted on the ground is one of the most common causes of this type of injury.

*If the medial collateral ligament remains intact, the lateral femoral condyle is forced down on the lateral tibial condyle and this causes a compression fracture.

*Older patients with osteoporosis are the most prone to this type of injury. There may be a hemarthrosis, and the lateral tibial plateau will be tender.

*Compression fracture of the lateral tibial plateua, resulting in separation at the margin of the plateau or depression of the central portion of the artucular surface.

*A valgus injury of the knee may result in a fracture of the lateral tibial plateau. At times these fractures are difficult to identify and are obvious only on oblique radiographs.

*The fractures consist of either a vertical split through or a depression of a portion of the joint surface. There may be an associated fracture of the neck of the fibula.

*When the fracture involves the lateral margin of the plateau or is associated with a fracture of the fibula, an accompanying disruption of the medial collateral ligament is likely.

*Treatment: Stabilisation and fixation where required.

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