Journal of Musculoskeletal Trauma

Arthroscopic Assisted Intra-Articular Reduction and Internal Fixation of Tibia Plateau Fracture: Dong Hwi Kim, Gwang Chul Lee, Kwi Youn Choi, Sung Won Cho, Sang Ho Ha; J Korean Fract Soc 2013;26(3):191-198. Published online July 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.3.191

PURPOSE
We evaluated the results of arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window along with any additional bone grafts.
MATERIALS AND METHODS
From March 2006 to March 2009, twelve patients with arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures over 5 mm in depression and displacement on the articular surface in computed tomography (CT) were enrolled in this study. We reduced or removed the depressed fracture fragment using freer without making a cortical window. Then, we accomplished internal fixation by a cannulated screw. All cases have not received bone graft. Both the postoperative clinical and radiological results were evaluated by the Rasmussen system.
RESULTS
The fractures were healed completely in an average of 9 (range from 7 to 12) weeks. According to Rasmussen classification, we obtained satisfactory clinical results as excellent in 8 cases, good in 3 cases, and fair in 1 case; and radiological results were excellent in 7 cases and good in 5 cases.
CONCLUSION
We consider that arthroscopic intra-articular reduction and internal fixation of tibial plateau fractures without cortical window and any additional bone grafts is are a useful methods for attaining satisfactory results.

Citations

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Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Comparison of Floating Knee according to Presence of Knee Joint Injury: Eau Sup Chung, Jong Hyuk Park, Hee Rack Choi, Joo Hong Lee, Kwang Bok Lee; J Korean Fract Soc 2012;25(4):277-282. Published online October 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.4.277

Abstract PDF: PURPOSE
To compare the clinical outcomes of floating knee according to the presence of knee joint injury.
MATERIALS AND METHODS
Between March 2004 and March 2009, we investigated 36 patients, who underwent surgical treatment for floating knee injuries. We classified the floating knee into two groups as type I (12 cases) has no knee joint injury and type II (24 cases) has knee joint injury. We compared two groups about combined injury (orthopedics or other part), open fracture or not, neurovascular injury,union time, range of motion, and complication rate.
RESULTS
There is statistically no significant difference between two groups as type I (6 cases, 50%) and type II (13 cases, 54.2%) in orthopedic combined injury (p=0.813), and also same as type I (3 cases, 25%) and type II (12 cases, 50%) in combined injury on the other department (p=0.151), and in floating knee with open fracture as 4 type I (33%) and 12 type II (50%) of 16 cases (44%), and Gustilo-Anderson 3 type I, 4 type II, 1 IIIA, 4 IIIB, and 4 IIIC (p=0.423). There is statistically no significant difference between two groups in neurovascular injury as 1 type I (8.3%), and 3 type II (12.5%) (p=0.708). There is a statistically significant difference between two groups in the mean bone union time as 18.2+/-5.37 weeks (12~24 weeks) for type I and 24.95+/-9.85 weeks (16~33 weeks) for type II (p=0.045), and in the mean range of knee joint motion as 133+/-12.74 degree (120~150 degree) for type I and 105+/-19.00 degree (80~135 degree) for type II (p=0.012).
CONCLUSION
Floating knee with knee joint injury is severe itself and related with severe combined injuries, subsequent range of knee joint motion limitation, the delay of union time, and high complication rate. Therefore, we should take care in surgical treatment for this trauma entity.

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Popliteal Artery Injury Associated with Fracture and/or Dislocation of the Knee: Jun Young Yang, Kwang Jin Rhee, June Kyu Lee, Deuk Soo Hwang, Ki Yong Byun, Taek Soo Jeon; J Korean Soc Fract 2000;13(3):494-500. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.494

Abstract PDF: PURPOSE
To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option.
MATERIALS AND METHODS
We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999.
RESULTS
Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows : good 5 cases, fair 3 cases, and poor 3 cases.
CONCLUSION
Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.

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The Ilizarov Method for the Treatment of Open Intraarticular Fractures around the Knee Joint: Clinical Analysis of 6 Cases: Chang Hyouk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Yong Joo Kim; J Korean Soc Fract 1996;9(1):119-128. Published online January 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.1.119

Abstract PDF: There are many difficulties in treating open intraarticular fracture around the knee joint because of its combined neurovascular injury and comminution of fracture site. The difficulties lie in choosing a fixation method, postoperative care, and analyzing the results of the treatment. Recently there is growing preference in using Ilizarov apparatus. The merits of Ilizarov in fracture treatment are early weight bearing and easy compression and distraction. In cases of this study, difficulties were subclassified into problems, obstacles. and complications. Six cases of open intraarticular fracture around the knee joint were treated from Mar., 1993 to Aug.,1994 and the average follow up period was twenty months and the results were as follows: 1. Of the six patients, there were five males and one female patients. 2. The cause of the fractures was traffic accident in five and crushing injury in one. 3. Of the six cases, five cases were combined femoral and tibial fractures and one case was only femoral condylar fracture. 4. In follow up study, there was thirty cases of difficulties such as pin site problem, pain, limitation femotion, and nonunion etc. 5. Of the seventy-four wires, pin site problem occurred at twenty pins but open wounds were cured without infection evidence. 6. The results were poor in all cases. 7. The Ilizarov technique requires adequate implantation and management to reduce an overall complication rate and improve functional results.

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Popliteal Artery Injuries Associated with Trauma Around the Knee: Myung Chul Yoo, Chung Soo Han, Kye Lim Lee, Moon Hwan Lee; J Korean Soc Fract 1989;2(1):34-41. Published online June 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.1.34

Abstract PDF: Between Jan. 1980 and Dec. 1987, 47 cases in 44 patients with politeal artery injury associated with trauma around the knee joint were managed at Department of Orthopaedic Surgery, KMC. Authors analysed the diagonstic methods, operations with its results and prognostic factors, and the results were as follows: 1. The incidence was 3%(44/1473) from Jan. 1980 to Dec. 1987 2. 14 cases of 19 cases, who underwent the vascular surgery, were survived(74%) and further amputations were applied to failed 5 cases. 3. Doppler flowmeter was considered as very useful diagnostic tool because of simplicity, safety, and accuracy, therefore angiography was not necessary in all cases. 4. The length of ischemic time and the amount of associated soft tissue damage were considered as important prognostic factors. 5. Vein graft was considered as good operative technique, but thrombectomy alone was not enough method for politeal artery injury. 6. ligament repair was not always necessary in treatment of popliteal artery injury associated dislocation of knee. 7. Prophylatic decompression was necessary in all cases after vascular surqery and fibulectomy fasciotomy was considered as outstanding technique.

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