Prevalence of Meniscus Tear in Tibial Plateau Fractures

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.

Fracture of the Medial Tibial Condyle in Unicompartmental Knee Arthroplasty: Report of 3 Cases

Unicompartmental knee arthroplasty(UKA) has become a popular method of treatment for medial osteoarthritis recently. UKA is now performed through minimally invasive surgery and it offers potential advantages including less postoperative pain, reduced blood loss, early rehabilitation, quicker recovery of range of motion and lower complication rate. Fracture of the medial tibial condyle is a relatively rare complication of UKA but it affects the prognosis of the implants and patient. We experienced 3 cases of medial tibial condylar fracture after UKA. Two cases were managed with open reduction and screw fixation, and one case was treated conservatively. All of the three patients were satisfied with the final outcome, so we report the cases of the medial tibial condylar fracture after UKA.

Operative Treatment of Fracture of the Tibial Condyle / 대한정형외과학회잡지

The fracture of the tibial condyle involving the articular surface can produce some disability of the knee joint because it is frequently accompanied by soft tissue injury to the ligaments and menisci. Accurate anatomical reduction and rigid internal fixation with early mobilization is known to provide good results. The authors analysed 50 cases of the fracture of the tibial condyle which were treated with recent method(anatomical reduction, rigid fixation and early joint motion) at the Dae Han Hospital from January, 1988 to May, 1993. The results were summerized as follows: 1. The associated injuries were ligamentous injury in 24 cases(48%), fibular fracture in 21 cases(42%), femur fracture in 7 cases(14%) and meniscal injury in 7 cases(14%). 2. According to Hohl's classification, the split compression type was most common in 17 cases(34%), and there were 14 comminuted type(28%), 8 local compression type(16%), 7 total condylar compression type(14%) and 4 split type(8%). 3. Method of internal fixation were plate & screw in 32 cases(64%), tibial bolt & screw in 18 cases(36%), bone graft in 31 cases(62%), ligament repair in 24 cases(48%) and menisectomy in 4 cases(8%). 4. The clinical result by Insall's criteria were excellent in 37 cases(74%), good in 8(16%), fair in 3(6%), poor in 2(4%) among 50 cases.

Knee Ligament Injuries Combined with Tibial Condyle Fracture: Clinical Study of 30 Patients / 대한정형외과학회잡지

Injuries to the ligament, bone and other supporting structures of the knee joint have a tendency to increase becsuse of the increasing traffics, popularity of sports and industrial accidents. It is well known that the knee joint is burdened on motion and weight bearing and structurally it is more frequently injuried than other joints. When there is injury to the knee, it is frequently combined with injury to ligaments and other supporting structures rather than pure tibial condyle fracture. There remains a residual instability of the knee joint because of neglecting of the injured ligaments if treatment is concerned only with tibial condyle fracture. To obtain complete recovery from the injury, early diagnosis, prompt treatment and well planned exercise are important. Thirty patients with ligaments injury and tibial condyle fracture who were treated at the Depsrtment of Orthopaedic Surgery of Wallace Memorial Baptist Hospital from 1983 to 1987 have been reviewed. Through combined operative and conservative treatment, excellant and good results were obtained in 93% of the cases.

A Clinical Study of the Tibial Condylar Fracture / 대한정형외과학회잡지

The knee joint is one of the major weight bearing joint in the body, and is frequently injured because of its complex motion despite of a simple bony architecture. In the fracture of the tibial condyle the injuries of soft tissues such as ligaments and menisci are frectuently accompanied, and the weight bearing surface is involved. So it often produces a disability of the knee joint. Forty-seven consecutive cases of the tibial condylar fracture treated at the orthopaedic department of the Hallym Medical College from 1982 to 1985 have been analyzed according to its type, radiologic diagnosis, treatment, and end results. The conclusions are; 1. The tomography is important in the decision of the treatment method by the accurate measurement of the extent of depression and displacement. 2. The poor results are usually caused by a severe comminution and some associated injuries such as menisus tear, open wound, and rupture of ligamentum patellae etc. 3. The better results can be obtained with the treatment of early exercise within 6 weeks, of weight bearing between 12-20 weeks, and in surgical cases, within 2 weeks and with a bone graft.

A Clinical Study of the Tibial Condylar Fractures / 대한정형외과학회잡지

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.