Posterior Keen Dislocation with Anterior Tibial Plateau Fracture: Report of 25 Cases / 昆明医科大学学报

ABSTRACT

Objective To discuss the injury mechanisms of posterior keen dislocation with anterior tibial plateau fracture and to provide theoretic support for clinic diagnosis and treatment.Methods Total of 25 cases with posterior knee dislocation and anterior tibial plateau fracture were enrolled from June,2009 to June,2012.Injury mechanisms were analyzed from the point of view of mechanics by combining with detailed histories,X-ray,CT scan and MRI results,and surgical findings.Results All of 25 cases were high-energy injury,with 13 falling from heights (about 2-5 meters),10 injured in traffic accident,1 falling down by carrying heavy backpacks and 1 rolling down hill.Posterior knee dislocation with the anterior tibial plateau fracture were found in all the 25 cases,among which 5 cases were with common peroneal nerve injury and popliteal artery rupture,and 1 case was with capitulum fibulae fracture and the rest were with no obvious artery nerve injury One years after operation,the average HSS score of the knee joint was 88.5 and the excellent and good rate was 93.7％.Conclusion The main reason of the backward dislocation of knee joint with the anterior border fracture of tibial plateau was high energy trauma and it was a new type of fracture-dislocation of knee joint.After backward dislocation of knee joint,we should carefully check whether there is the anterior-edge fracture of tibial plateau before operation to avoid misdiagnosis;reduction of the anterior-edge fracture of tibial plateau must be done Anatomically in operation,which can reduce the occurrence of instability of knee joint after operation and improve the operation effect.