Journal of Musculoskeletal Trauma

Original Articles

Meniscal Injuries with Tibial Plateau Fractures: Yong In, Won Jong Bahk, Oh Soo Kwon, Chae Gwan Kong, Ju Young Kim; J Korean Soc Fract 2003;16(4):490-495. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.490

Abstract PDF: PURPOSE
The purpose of this study is to evaluate by arthroscopy the incidence of meniscal injury and the result of its treatment in fractures of the tibial plateau.
MATERIALS AND METHODS
From March 2000 to July 2002, twenty-three patients with tibial plateau fractures were examined and treated by arthroscopy before reduction of the fractures. Following the classification by Schatzker, there were 3 pure cleavage fractures (type I), 7 with cleavage and depression (type II), 4 with pure central depression (type III), one medial condyle fracture (type IV) and 8 with meta-diaphyseal fractures (type VI). Meniscal injuries were treated by meniscectomy or meniscal repair. Second look arthroscopy for patients treated with meniscal repair were performed at 6 months after operation or at time of the fixative removal.
RESULTS
Thirteen knees (56%) were found to have meniscal injuries. There were 11 lateral meniscal tears, eight of which were periphral and repaired. There were 3 complex lateral meniscal tears which required partial meniscectomy. The five medial meniscal tears were required all partial meniscectomy. Six of the eight patients who were repaired the meniscal tears evaluated by second look arthroscopy. Five patient showed complete healing and one showed incomplete healing.
CONCLUSION
Every effort should be made to repair the meniscal tears in tibial plateau fractures.

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Risk Group of Lateral Meniscus Injury in Fracture of Lateral Tibial Condyle: Jung Man Kim, Cheong Ho Chang, Doo Hoon Sun, Jeong Tae Seo, Seok Joong Kim; J Korean Soc Fract 1999;12(3):601-606. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.601

Abstract PDF: PURPOSE
Untreated meniscus injuries accompanied with fractures of lateral tibial condyle may cause prolonged pain and post-traumatic arthritis. Lateral displacement of fractured fragment of lateral tibial condyle was found to be related to the incidence of lateral meniscus tear. We established the risk groups for lateral meniscus injuries on the basis of the degree of the lateral displacement of lateral tibial condyle.
MATERIALS and METHODS
Risk groups for lateral meniscus injury in fractures of lateral tibial condyle were evaluated in 39 knees, retrospectively, using plain roentgenograms and arthroscopic findings. On the knee anteroposterior radiography, displacement of lateral tibia condyle were classified into three groups according to the probability of lateral meniscus INJURY: high risk group for above 8mm of lateral displacement; moderate risk group for 4-8mm; low risk group for less than 4mm.
RESULTS
High risk group has ten meniscus injuries among 13 knees(76.9%) and moderate risk group had the seven meniscus injuries of 18 knees(38.9%). Low risk group of eight knees had no meniscus injury(0%). These different incidences among groups were statistically significant(p<0.05).
CONCLUSIONS
The authors suggest that the incidence of lateral meniscus injury was related to the degree of lateral displacement of lateral tibial condyle, and our definition of risk groups are useful for prediction of lateral meniscus injury in fracture of lateral tibial condyle.

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Injuries of the Knee Associated with Fractures of the Tibial Shaft: Kwang Won Lee, In Sung Hwang, Seung Hun Lee, Tae Gyoo Ahn, Ha Yong Kim, Whoan Jeang Kim, Won Sik Choy; J Korean Soc Fract 1999;12(2):277-283. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.277

Abstract PDF: Two hundred and seventeen consecutive patients with two hundred and twenty five diaphyseal tibia fractures were retrospectively reviewed to evaluate the frequencies, types and the results of treatments for the associated ipsilateral knee ligaments and menisci injuries from May 1993 to Feb 1997 at Eulji Medical College Hospital. Average follow-up period was 41 months(20~65 months). Thirteen patients with knee injuries(5.8%) were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Eleven patients(84.6%) were diagnosed as having a ligament or meniscus injury at the time of initial management. The posterior cruciate ligament(PCL) was injured in eight patients(50%); the anterior cruciate ligament(ACL), in three; the medial collateral ligament, in three; the lateral collateral ligament, in two: the medial meniscus, in two; and the lateral meniscus, in two. There was no relationship between specific ligament damage and the cause of the injury or level of fracture. Collateral ligament injuries, two ACL, and four PCL injuries were treated conservatively and one PCL injuries were treated with pull-out suture technique and another four PCL injuries were treated with reconstruction using bone-patella tendon-bone. One ACL injury was treated with reconstruction using semitendinosus tendon. As evaluated by the method of HSS knee score, there were seven(53.9%) excellent, four(30.8%) good, and two fair(15.3%). On the basis of the results of this study, we believe that, after stabilization of a fracture of the tibial shaft, it is essential to examine the knee throughly to identify any associated ligamentous injuries.

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