Journal of Musculoskeletal Trauma

Prevalence of Meniscus Tear in Tibial Plateau Fractures: Jung Man Kim, Dong Yup Lee, Young Joon Yang; J Korean Fract Soc 2006;19(3):319-321. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.319

Abstract: PURPOSE
To evaluate the pattern of meniscal tear according to the type of the tibial plateau fracture of Schatzker.
MATERIALS AND METHODS
Sixty two cases of tibial condyle fracture treated between the period of 1994 and 2003 were evaluated. The fracture type was classified according to Schatzker. The pattern and extent of the meniscus tear were compared with the fracture classification. Statistical analysis was made with the Fisher's exact test.
RESULTS
Meniscus tear was noted in 29 cases out of 62 fractures (46.8%). The twenty cases of minimally displaced fractures treated conservatively showed no meniscal tear. Of 18 cases of the most common type I fracture 2 (11.2%) had a meniscus tear. Of 16 type II fractures 12 (75%) had a meniscus tear. The type III fracture showed the highest prevalence of meniscus tear (76.9%, 10/13). There was statistically significant relationtionship between the type of fractures and the rate of meniscus tear (p<0.0001).
CONCLUSION
The meniscus tear frequently occurred in tibial plateau fractures in Schatzker type II and III. Associated meniscus tears should be born in mind when those types of fracture are encountered.

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A STUDY OF ANATOMICAL CONFIGURATION OF LATERAL TIBIAL CONDYLE USING MR AXIAL IMAGE: Sung Do Cho, Yong Sun Cho, Bum Soo Kim, Tae Woo Park, So Gu Lew, Su Young Jung; J Korean Soc Fract 2001;14(3):398-403. Published online July 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.3.398

Abstract PDF: PURPOSE
To evaluate the anatomical configuration of the lateral tibial condyle using the MR axial images and to present the proper configuration of the head of the buttress plate that fit the lateral tibial condyle of Korean MATERIALS AND METHODS: With 110 MR axial images of the knee joint of male and female, we calculate the ratio of the maximal height of the arc of the l ateral tibial condyle to the length of the line between the end point of the arc of the lateral tibial condyle(the ratio of convexity) and the angle of the peak point of arc of the lateral tibial condyle(the angle of convexity), the absolute value of the difference of the angle of the end point of the arc(the value of symmetry) of that. then we evaluate the head of 3 the buttress plates with same methods and then compare with the result of the lateral tibial condyle.
RESULTS
The ratio and angle of convexity of Korean were average 0.216/49.04(total), 0.203/49.35(male), 0.235/50.36(female), and the value of symmetry were average 5.68(total), 5.76(male), 5.56(female). the ratio and angle of convexity of the head of buttress plate were average 0.177/43.21(EGIRE), 0.114/25(AO), 0.101/23.83(Solco) and the value of the symmetry were 1.643(EGIRE), 0.75(AO), 1.5(Solco). the ratio of convexity was correlated with age, height, and weight but angle of convexity was not correlated with weight.
CONCLUSION
The anatomical configuration of the lateral tibial condyle of Korean did not fit that of the head of the buttress plates and it would be necessary to make a new plate that fit the lateral tibial condyle for Korean.

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Surgical Treatment for Tibial Condyle Fracture of the Proximal Tibia: Won Tae Choi, Bo Yel Choi, Chul Hyung Lee, Eui Soon Kim, Jeong Woung Lee, Doo Hoon Sun, Myung Sang Moon; J Korean Soc Fract 2001;14(2):291-297. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.291

Abstract PDF: PURPOSE
To evaluate the results of operative treatment for tibial condyle fracture of the proximal tibia. MATERIAL AND METHODS: From March 1995 to June 1999, 15 patients with more than one year follow-up periods were treated by operative method at Sun General Hospital. 10 of them were treated by open reduction and internal fixation(plate & screw for 8, screw & K-wire for 2) and 5 of them by closed reduction and Ilizarov fixation. Preoperative prognostic factors were considered as the fracture type of Schatzker classification, associated injury, and closed or open fracture. Functional outcome was evaluated results by Blokker`s criteria.
RESULTS
According to Schatzker classification, type III were 4 cases, type IV were 6 cases, and type V were 5 cases. At last follow up, average range of motion was 115degrees (Internal fixation was 110degrees, External fixation was 130degrees) The results was according to Blokker`s criteria, 11 cases(73%) had satisfactory acceptable results, among 4 cases(27%) of non-acceptable criteria.
CONCLUSION
For treatment of tibia condyle complicated communited fracture, we are able to consider that rigid internal fixation with anatomical reduction and external fixation for early range of motion.

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Treatments of the Tibial Condylar Fractures: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yu, Hong Man Cho; J Korean Soc Fract 2000;13(2):311-319. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.311

Abstract PDF: PURPOSE
: In the proximal tibial condylar fractures, the authors analyzed the treatment results clinically and radiologically, after arthroscopically assisted accurate anatomical reduction of articular surface and rigid internal fixation with early mobilization.
MATERIALS AND METHODS
: We reviewed 56 cases of tibial condylar fracture that were treated at our the orthopaedic department between January 1990 and December 1996 and the follow-up period was 1 year above. According to Schatzker's classifications, we classified the type of fracture and we analyzed the results by average union time and Porter's criteria after accurate anatomical reduction of articular surface and rigid assisted redcution of articular surface and internal fixation.
RESULTS
: According to Schatzker's classification, Type I 15cases, TypeII 14cases, TypeIII 6 cases, TypeIV 7cases, TypeV 3cases, TypeVI 11cases, Associated soft tissue injuries were total 22cases the were MCL injuries 12 cases, lateral meniscal injuries 6 cases. The average union time was 15.5 weeks and by Porter's criteria, 56 cases, of which 39 cases(71%) had an good result.
CONCLUSION
: we considered that good results can be obtained by assistant use of arthroscopy and rigid internal fixation with early mobilization, that accurate diagnosis and appropriate treatments of accampaning injuries according to the type of fractures, and accurate anatomical reduction of articualr surface.

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Arthroscopically-assisted Reduction and Fixation for the Lateral Tibial Condyle Fractures: Jeong Hwan Oh, Seon Nam Kim; J Korean Soc Fract 1999;12(3):614-621. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.614

Abstract PDF: PURPOSE
Retrospective study was performed about arthroscopically-assisted reduction and internal fixation for the lateral tibial condyle fractures to evaluate the usefulness of arthroscopy. MATERIAL AND METHODS: From January 1993 through December 1996, 36 patients with tibial plateau fractures were evaluated. After reviewing the records and radiologic studies, 22 patients were included in the study based on fracture patterns. Average follow up were 26 months, with a range of 12 to 45 months. Among the 22 cases, 16(72.7%) were male and 6 (27.3%) were female. Fourteen(72.6%) were caused by traffic accident(9 pedestrians, 5 passengers) and 7 were fall from a height. According to Schatzker classification, 9 cases (40.1%) were classified as cleavage with depression(type II), 5 cases(22.4%) of pure central depression(type III) and 8 cases(36.5%) of pure cleavage(type I). There were 24 cases of associated injuries in 16 patients, among which lateral meniscus tears was most common (37.5%). We used Porters criteria for the clinical evaluation and Blotters criteria.
RESULTS
By Porters criteria for the clinical evaluation, acceptable results were obtained in 20 cases (90.9%) in symptom, 21 cases(95.5%) in functional aspect and 22 cases(100%) in appearance and radiologic appearance. By Blotters criteria, satisfactory results were in 20 cases (90.9%).
CONCLUSION
Arthroscopically-assisted reduction and internal fixation should be considered one of the treatment of choice in selected tibial plateau fractures from many advantages.

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Arthroscopically-Assisted Reduction and Fixation in Fractures of the Tibial Condyle: Jung Su Hwang, Han Chul Kim, Yong Soon Kim; J Korean Soc Fract 1999;12(1):90-97. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.90

Abstract PDF: Fractures of the tibial condyle are characterized that often involve the articular surfaces and frequently associated with soft tissue injuries such as collateral ligament, cruciate ligament and menisci of the knee. The author analyzed 12 cases of tibial condyle fractures, which were surgically treated by reduction of depressed articular surface under assist of arthroscopy and then fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 9 cases of the 12 cases. The purpose of this study are (1) obtaining accurate reduction of the depressed articular surface, (2) preventing knee joint from the surgical wide dissection, (3) not only bony problems but also combined menisci and ligament injuries were diagnosis and management. We can obtain more anatomical reduction and excellent or good functional knee score since extensive exposure is avoided. There is no complication with regard to arthroscopic surgery and rapid recovery with reduced pain and early full ROM are obtained after follow-up study of a mean of 1 year.

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Treatments of Tibial Condylar Fractures: Yong Bum Park, Chung Soo Hwang, Phil Hyun Chung, Suk Kang, Dong Ju Chae, Han Chul Kim, Sang ho Moon, Seung Hun Lee, Tae Young Kim, Sun Hyun Yun; J Korean Soc Fract 1998;11(4):790-797. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.790

Abstract PDF: The tibial condylar fractures are characterized by intra-articular extension of fracture line and associated soft tissue injuries, and could affect knee alignment, stability, adn range of motion after treatments. Therefore, anatomical reduction and rigid internal fixation is mandatory to get satisfactory results. But this method of treatment can not be always possible due to technical dimend of surgical sklls and high risk of postoperative infection. The authors analyzed 43 cases of tibial condylar fractures, which were treated at the orthopaedic department of the Dongguk University Hospital from March 1990 to May 1996. Males were 34, and females were 9. Average age of patients was 41.4 years, and average follow up period was 18 months. The most common causes of injuries were traffic accidents (36 cases), and most common type of fracture was Schatzker type I. associated soft tissue injuries were observed in 21 cases. Treatment methods were chosen by degree of displacement of fracture fragment and associated soft tissue injuries. Conservative treatments were done in 23 cases and operative treatments in 20 cases. Satisfactory results were obtained in overall 32 cases(74%) regardless of the methods of treatment. Unsatisfactory results were observed in patients who had associated soft injuries and significant displacement of fracture. Conclusively, satisfactory results could be obtained in patients with tibial condylar fractures by appropriate selection of treatments according to displacement of fracture and associated soft tissue injuries.

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Treatment of the Tibial Condyle Fracture: Sung Ho Han, Bo Gyu Yang, Chi Hong Kim, Tae Won Ahn, Sun Tae Jeong; J Korean Soc Fract 1998;11(1):214-225. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.214

Abstract PDF

A fracture of the tibial condyle is an intra-articular fracture of a major weight bearing joint and loss of function result in high percentage disability of the extremity. The goal of tibial condyle fracture management is a stable, well-aligned, congruent joint, with a painless range of motion and function. The management of tibial condyle fractures remains controversal. Many authors have stated that anatomical restoration of the articular surface and stable internal fixation are essential for these goals to be attained, but good results have also been reported after the conservative treatment. So the method of treatment has to be selected in each individual cases. We evaluated the 35 tibial plateau fractures, 17 treated by conservative method and 18 treated by surgery, at an average follow up of 17 months. The results were obtained as follows; 1. The most common cause of injury was motor vehicle accident in 25 cases(71.5%). 2. According to Schatzker classification, the most common type was typeII in 12 3. Associated soft tissue injuries were in 19 cases(54.3%). Among these, meniscal injuries were most common(in 13 cases). 4. According to Hohl and Luck criteria, the clinical results were acceptable in 11 to 17 cases (64.7%) after non-operative methods and 14 of 18 cases(78%) after operative methods.

Citations

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Evaluation of the Patterns of Fractures and the Soft Tissue Injury Using MRI in Tibial Plateau Fractures
Ji-Yong Chun, Hee-Gon Park, Sung-Su Hwang
Journal of the Korean Fracture Society.2007; 20(4): 302. CrossRef

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Arthroscopic Management of the Tibial Condylar Fractures: Do Hyun Moon, Beom Koo Lee, Jin Hong Ko, Ki Dong Kang, In Seok Oh, Young Kab Shin; J Korean Soc Fract 1997;10(2):324-331. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.324

Abstract PDF

The tibial condylar fracture is a fracture of the proximal end of the tibia, involving as they do weight-bearing articular sufaces and frequently accompanied by soft tissue injuries and menisci present a variety of problems in the treatment and prognosis. We performed reduction of the depressed articular fragment under mornitoring of arthroscopy and under the control of image intensifier and fixed with cannulated cancellous screws and accompanied by bone graft in 7 cases of the 11 cases. The results were satisfactory Arthroscopy bridges the advantage of accurate reduction and fixation without extensive operative exposure. In addition, arthroscopy allows through lavage, removal of loose fragment and accurate of associated intraarticular pathology. Since extensive exposure is avoided, rapid recovery with reduced pain and early full ROM us achieved in patients managed arthroscopically.

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Citations to this article as recorded by

Arthroscopically Assisted Reduction and Internal Fixation of Intra-Articular Fractures of Tibial Plateau
Jeung Tak Suh, Jae Min Ahn, Tae Wan Kim, He Myung Cho
Journal of the Korean Orthopaedic Association.2012; 47(2): 96. CrossRef

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