RESUMO
The tibial condylar fractures 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 motion is known to decrease the complications. During a period of 10 years, from January 1978 to December 1987, we treated 105 tibial condylar fractures at Severance Hospital. Of the above, 77 cases have been analyzed according to the classification, cause of injury, method of treatment, final result and complication. The 77 cases were classified as follows ; total condylar depression 17(22%), undisplaced 16 (21 %), split compression 16(21 %), comminuted 14 (18%), local compression 5 (7%), split 1 (1%) and others 8(10%). Among these, 59 cases revealed the result of “ACCEPTABLE” according to Porter's criteria. Of the conservative group, 86% obtained the rating of “ACCEPTABLE” and 67% of the operative group did as well. Possible complications include traumatic arthritis (9), limited motion (9), wound infection (6), instability (3), angular deformity (2), intraarticular loose body (2), nonunion (1) and myositis ossificans.
Assuntos
Artrite , Classificação , Estudo Clínico , Anormalidades Congênitas , Depressão , Articulação do Joelho , Ligamentos , Métodos , Miosite Ossificante , Lesões dos Tecidos Moles , Infecção dos FerimentosRESUMO
The tibial condylar fracture is a fracture of the proximal end of the tibia, involving the srticular surface. This fracture frequently accompanied by soft tissue injuries such as collateral ligsment, cruciate ligament and menisci. Thirty cases of the tibial condylar fracture which treated Inchon Choong Ang Gill Hospital during the period from March, 1983 to February, 1986, the thirty cases could be followed for one year to four years. They have been analyzed according to its cause, classification, treatment and result. Among these 12 cases(40.0%) were treated by cast immobilization, 1 case(3.3%) by skeletal traction, 17 cases(56.7%) by open reduction and internal fixation. Twenty-three cases(76.7%) out of thirty revealed the rating of ACCEPTABLE according to Hohl and Lucks criteria.
Assuntos
Animais , Classificação , Estudo Clínico , Brânquias , Imobilização , Ligamentos , Lesões dos Tecidos Moles , Tíbia , TraçãoRESUMO
In planning treatment of tibial condylar fracture, the patient's age and physical condition, associated ligament injury and accurate fracture diagnosis, such as presence and degree of separatiori of split fragment, type of fracture and the severity of comminution must be considered. For accurate diagnosis, many kinds of methods including simple X-ray, arthroscopy, arthrography and tomography can be used. In spite of these procedures, sometimes we cannot know the accurate fracture morphology. The computed tomography(CT) has many advantages over other diagnostic methods. The application of CT in the evaluation of patients with spinal and pelvic fractures has been established, but rarely has its usefulness been noted in tibial condylar fracture. We thought that in assessing tibial condylar fracture, CT is more useful and accurate than conventional radiography. From March 1985 to August 1986, we took 17 patients(18 cases) of tibial condylar CT and were convinced with that it is a good diagnostic method. The results are as follows: l. In 5 cases, we could find a new fracture on CT film, which was impossible to be detected on simple X-ray. 2. In 7 cases, the fracture classification by plain X-rays was changed after CT check-up. 3. We could make the decision of treatment methods easily through more realistic classification and better recognition of split and comminution. 4. Proper approach could be done by understanding the accurate fracture size and localization.