Journal of Musculoskeletal Trauma

Original Articles

Knee Fractures and Ligament Injuries Associated with Ipsilateral Femoral Shaft Fractures: Mechanism of Injury, Site of th Knee Fracture and Ligament Injury: Dong Ju Chae, Phyl Hyun Chung, Won Suk Chae; J Korean Soc Fract 2000;13(2):230-235. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.230

Abstract PDF: PURPOSE
: To establish the incidence and type of knee fractures, injury of knee ligament associated with ipsilateral femoral shaft fractures. What is the most common mechanism of these combined injuries? MATERIALS AND METHODS : From March 1995 to February 1999, evaluation of one hundred and twenty consecutive patients with fracture of the femoral shaft showed fractures and injuries of the ligaments of the ipsilateral knee in thirty-five(29%) of them. Of those thirty-five, nineteen patients had injured their knees and femoral shaft fractures by the dashboard injury. Twelve injuries were caused in a motor cycle accident, and two patients occurred in pedestrians struck by cars. Two injuries were caused by falls.
RESULTS
: There were twenty fractures of th knee and fifteen injuries of the ligament. Seventeen of the twenty fractures were in the patella, two in the bicondyle of the proximal tibia and one in the lateral condyle of the proximal tibia. Eleven of seventeen fractures of the patella were open fractures. Of fifteen injuries of the ligament, there were six posterior cruciate ligament tears (including 2 partial tears and 1 avulsion fracture), three posterior cruciate ligament tears with medial or lateral collateral ligament disruption , three anterior cruciate ligament tears(2 tibial spine fractures and 1 partial tear), two lateral collateral ligament disruptions and one medial collateral ligament tear. The locations of femoral shaft fracture were proximal in four patients, middle in thirty, and distal in one patient.
CONCLUSION
: We conclude that there is a high incidence of ipsilateral fracture of the patella and posterior cruciate ligament tears in patients with femoral shaft fractures. The dashboard injury is the most common mechanism of the ipsilateral knee fractures and ligament tears with femoral shaft fractures.

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Limited Internal Fixation for the Treatment of the Pilon Fracture: Phil Hyun Chung, Suk Kang, Sang Ho Mun, Won Suk Chae; J Korean Soc Fract 1998;11(4):841-848. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.841

Abstract PDF: The intraarticular fractures of the distal tibia-so called pilon fracture or plafond fracture- were caused by high energy and axial compression forces arising from motor vehicle accidents or falls from a height, and it is frequently associated with severe vomminution and soft tissue injury. Expecially soft tissue injury has been considered as a difficult problems to treat these fractures and there has been many controversies in the methods of treatment. We analized 30 cases of pilon fracture who were treated by limited internal fixation from March 1992 to March 1997. the average follow up period was 26 months(from 15 to 50 months). The results as follow: 1. According to Ruedi and Allgower classification, Type I were 4(13%), Type II were 14(46%) and Type III were 12(40%) cases. 2. By using Ovadia and Beals' radiologic assessment, limited internal fixation showed good and fair results in about 80% of cases. 3. By using Mast and Teipner's clinical functional assessment, limited internal fixation showed good and fair reults in about 80% of cases. 4. Complications after operation were traumatic arthritis(17%) and nonunion(3.3%). But there were no complications such as wound infection and skin necrosis. Limited internal fixation with casting provides good result to treat pilon fractures and it reduces the complications of soft tissues problem.

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