[Ortho] Что делать с эпифизом tibia?

[vijay sata]

Dear Collegue
  I thank for attaching the CT scan. it makes all the details very clear.
  the approach should be standard posterior one (same that we use to fix the avulsed PCL).
  the fragment is rotated and hence may require some manipulation, especially in flexion of the knee joint.
  fixation may be with cancellous screw and washer.
  ONLY IMPORTANT THING IS THAT THE SURGERY MUST BE DONE VERY FAST, it is already 2 weeks old; 10 days more
and it will become very difficult. at present also a good mobilisation of artery and nerve would be
essential before proceeding with reduction otherwise there are good chances of injury to vasculature and
frustration of very difficult reduction.
  thanks again for such a nice case.
  please forward me the final management offered to the patient.
  with all the best always,
  vijay sata.
vijay sata