Journal of Musculoskeletal Trauma

Restoration of Lateral Tibial Plateau Widening and Articular Depression Is Necessary to Prevent Valgus Deformities after Arthroscopic Reduction and Internal Fixation in AO/OTA 41.B2 or B3 Fractures: Jun-Ho Kim, Kang-Il Kim, Sang-Hak Lee, Gwankyu Son, Myung-Seo Kim; J Korean Fract Soc 2024;37(3):125-136. Published online July 31, 2024; DOI: https://doi.org/10.12671/jkfs.2024.37.3.125

Abstract PDF: Purpose
This study examined the factors affecting valgus deformities after arthroscopic reduction and internal fixation (ARIF) in lateral joint-depression tibial plateau fractures.
Materials and Methods
Patients with lateral joint-depression tibial plateau fractures treated with ARIF were assessed retrospectively. The radiological evaluations included the articular depression distance (ADD) and the lateral plateau widening distance (LPWD) on preoperative and postoperative computed tomography. A postoperative valgus deformity was defined as valgus malalignment (mechanical axis ≥3°) and valgus deviation (Δmechanical axis of the operated knee from the healthy knee of ≥5°). Subgroup analyses based on a postoperative valgus deformity were performed to compare the clinical outcomes, including the range of motion, patient-reported outcomes measures, and failure and osteoarthritis progression. Furthermore, factors affecting the postoperative mechanical and Δmechanical axes were assessed.
Results
Thirty-nine patients were included with a mean follow-up of 44.6 months (range, 24-106 months). Valgus malalignment and valgus deviation were observed after ARIF in 10 patients (25.6%) and five patients (12.8%), respectively. The clinical outcomes were similar in patients with and without a postoperative valgus deformity. On the other hand, lateral compartment osteoarthritis progression was significantly higher in the valgus deformity group than in the non-valgus deformity group (valgus malalignment group: 50.0% vs 6.9%, p=0.007; valgus deviation group: 60.0% vs 11.8%, p=0.032). One patient with valgus deformity underwent realignment surgery at postoperative five years. The preoperative ADD and postoperative LPWD were significantly associated with the postoperative mechanical (both, p<0.001) and Δmechanical (ADD, p=0.001; LPWD, p=0.025) axes. Moreover, the lateral meniscectomized status during ARIF was significantly associated with the Δmechanical axis (p=0.019).
Conclusion
Osteoarthritis progression was highly prevalent in patients with postoperative valgus deformity. Thus, the restoration of lateral plateau widening and articular depression and preservation of the meniscus are necessary to prevent a valgus deformity after ARIF in lateral joint-depression tibial plateau fractures.

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Prediction of Concomitant Lateral Meniscus Injury with a Tibia Plateau Fracture Based on Computed Tomography Assessment: Wonchul Choi, Yunseong Choi, Go Tak Kim; J Korean Fract Soc 2018;31(4):132-138. Published online October 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.4.132

PURPOSE
This study examined whether any fracture pattern shown in computed tomography (CT) scan is associated with the presence of lateral meniscus (LM) injury in a tibia plateau fracture.
MATERIALS AND METHODS
Fifty-three tibia plateau fractures with both preoperative CT and magnetic resonance imagings (MRI) available were reviewed. The patient demographics, including age, sex, body mass index, and energy level of injury were recorded. The fracture type according to the Schatzker classification, patterns including the lateral plateau depression (LPD), lateral plateau widening (LPW), fracture fragment location, and the number of columns involved were assessed from the CT scans. The presence of a LM injury was determined from the MRI. The differences in the factors between the patients with (Group 1) and without (Group 2) LM injuries were compared and the correlation between the factors and the presence of LM injury was analyzed.
RESULTS
The LM was injured in 23 cases (Group 1, 43.4%) and intact in 30 cases (Group 2, 56.6%). The LPD in Group 1 (average, 8.2 mm; range, 3.0â€“20.0 mm) and Group 2 (average, 3.8 mm; range, 1.4â€“12.1 mm) was significantly different (p < 0.001). The difference in LPW of Group 1 (average, 6.9 mm; range, 1.2â€“15.3 mm) and Group 2 (average, 4.8 mm; range, 1.4â€“9.4 mm) was not significant (p=0.097). The other fracture patterns or demographics were similar between in the two groups. Regression analysis revealed that an increased LPD (p=0.003, odds ratio [OR]=2.12) and LPW (p=0.048, OR=1.23) were significantly related to the presence of a LM tear.
CONCLUSION
LPD and LPW measured from the CT scans were associated with an increased risk of concomitant LM injury in tibia plateau fractures. If such fracture patterns exist, concomitant LM injury should be considered and an MRI may be beneficial for an accurate diagnosis and effective treatment.

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The value of magnetic resonance imaging in the preoperative diagnosis of tibial plateau fractures: a systematic literature review
Gregoire Thürig, Alexander Korthaus, Karl-Heinz Frosch, Matthias Krause
European Journal of Trauma and Emergency Surgery.2023; 49(2): 661. CrossRef

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Analysis of Risk Factors for the Posterolateral Articular Depression and Status of Posterolateral Fragment in Lateral Condylar and Bicondylar Tibial Plateau Fractures with Joint Depression: Jung Yun Choi, Yong Woon Shin, Beom Jung Lee; J Korean Fract Soc 2013;26(4):241-247. Published online October 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.4.241

Abstract PDF

PURPOSE
To evaluate risk factors of posterolateral articular depression and characteristics of the posterolateral fragment in lateral condylar and bicondylar tibial plateau fractures with joint depression.
MATERIALS AND METHODS
We reviewed 48 patients of Schatzker type II and type V (type II 34, type V 14) and evaluated risk factors of posterolateral articular depression according to the posterolateral fragment, fibular fracture, and Schatzker classification. We evaluated the position of articular depression and anterolateral fracture line of the posterolateral fragment and measured anterior to posterior lengths of the posterolateral fragment.
RESULTS
Posterolateral articular depression was found in 20 of 34 cases (59%) with coexisting posterolateral fragment and in 16 of 21 cases (76%) with coexisting fibular fracture. There was a significant difference in the occurrence of posterolateral articular depression with the existence of the posterolateral fragment and fibular fracture (p<0.001). Multivariate regression analysis revealed that fibular fracture increased the occurrence of posterolateral articular depression (odds ratio 24.5, 95% confidence interval 2.2-267.2). Fifty-seven percentage of the anterolateral fracture line of the posterolateral fragment existed posterior to the anterior margin of the fibular head.
CONCLUSION
This study showed that fibular fracture affects posterolateral articular depression in Schatzker type II and V tibial plateau fractures. Selecting a fixation device and performing fracture reduction requires a careful consideration since the anterolateral fracture line of the posterolateral fragment exists posterior to the anterior margin of the fibular head.

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Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Treatment of Tibial Plateau Fractures Using a Locking Plate and Minimally Invasive Percutaneous Osteosynthesis Technique: Hee Gon Park, Dae Hee Lee, Kyung Joon Lee; J Korean Fract Soc 2012;25(2):110-116. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.110

Abstract PDF: PURPOSE
To acknowledge the importance of precise reduction of articular surface of tibial plateau fractures and to make a guideline of treatment by evaluating outcomes and effectiveness of using locking plate and minimally invasive percutaneous osteosynthesis technique.
MATERIALS AND METHODS
Twenty-nine patients who underwent surgery for tibial plateau fracture from November 2005 to March 2010 were enrolled with 12 months follow-up in a retrograde manner. The Shatzker classification was used to classify fractures, and we used lateral submeniscal approach to make a precise reduction of articular surface. Radiologic evaluation was determined by presence of bone union, malalignment, and reduction loss or joint depression of articular surface. Post-operative infection, time of active movement of the knee joint, time of partial weight loading, and range of motion (ROM) of knee joint were evaluated. Lysholm Knee Score was used for functional evaluation.
RESULTS
Bone union took place in all but one case that developed osteomyelitis. Angulation deformity of more than 10degrees and reduction loss or joint depression of more than 5 mm were not observed. There was one case of osteomyelitis and one case of superficial surgical site infection. There were satisfactory clinical results, with an average time of active knee joint movement and weight loading of 6 weeks. The average ROM of knee joint was 125degrees in the last follow up. As for functional evaluation using Lysholm Knee Score, cases showed an average Lysholm Knee Score of 94 which was a satisfactory result.
CONCLUSION
In cases of tibial plateau fractures, if a surgeon accurately reduces the articular surface of joint and use minimally invasive locking plate it will help in bone union biologically, reducing the incidence of soft tissue injuries, and biomechanically maintaining the articular surface of the joint, proving itself to be a useful method of treatment.

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The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures: Yeung Jin Kim, Soo Uk Chae, Jung Hwan Yang, Ji Wan Lee, Dae Han Wi, Duk Hwa Choi; J Korean Fract Soc 2010;23(1):26-33. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.26

Abstract PDF

PURPOSE
To assess the behaviour of fresh frozen cancellous allograft used for supporting the reconstructed articular surface in impacted tibial plateau fractures.
MATERIALS AND METHODS
Between May 2004 and May 2008, 13 cases of impacted tibial plateau fracture were evaluated retrospectively. All fractures were treated with open reduction-internal fixation after restoration of the tibial plateau surface and insertion of fresh frozen cancellous allograft chips for subchondral support. Mean age was 46.6 (31~65) years. Average follow-up period was 36 (13~58) months. The radiological and clinical result for every patient was assessed according to the modified Rasmussen's system and Lysholm's knee score.
RESULTS
According to last follow-up weight bearing A-P X-ray, the fresh frozen cancellous allograft incorporated soundly in all cases and no complications such as joint depression, fracture reduction loss, angular deformity, and malunion were found. The mean time to complete bone union was postoperative 10+/-0.7 weeks. The mean range of motion was 135 (115~145) degrees. The mean Rasmussen's radiological score at last follow up was 15.3 (10 cases: excellent, 3 cases: good). The mean Lysholm's knee score at last follow up was 88.2+/-4.3.
CONCLUSION
We concluded that fresh frozen cancellous allograft in impacted tibial plateau fractures showed good results in terms of bone union and functional improvement and was considered to be a good structural supporter.

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Autograft versus allograft reconstruction of acute tibial plateau fractures: a comparative study of complications and outcome
Abolfazl Bagherifard, Hassan Ghandhari, Mahmoud Jabalameli, Mohammad Rahbar, Hosseinali Hadi, Mehdi Moayedfar, Mohammadreza Minatour Sajadi, Alireza Karimpour
European Journal of Orthopaedic Surgery & Traumatology.2017; 27(5): 665. CrossRef
Treatment of Tibial Plateau Fractures Using a Locking Plate and Minimally Invasive Percutaneous Osteosynthesis Technique
Hee-Gon Park, Dae-Hee Lee, Kyung Joon Lee
Journal of the Korean Fracture Society.2012; 25(2): 110. CrossRef

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Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating: In Jung Chae, Sang Won Park, Soon Hyuck Lee, Won Noh, Ho Joong Kim, Seung Beom Hahn; J Korean Fract Soc 2009;22(4):252-258. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.252

Abstract PDF

PURPOSE
To evaluate the radiologic and clinical results of treatment of the Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual incision approach and dual plating. MATERIALS AND METHODS: Twelve cases in eleven patients of Shatzker type 6 tibia plateau fracture which has been treated using the lateral and posteromedial dual incision approach and dual plating were analyzed with an average follow-up of 16 months. Times to union, alignment and reduction loss on radiograph and postoperative clinical outcome with checking the range of motion of the knee joint, Knee Society Score and UCLA activity scale were analyzed and evaluated. RESULTS: In all cases, bony union was obtained in an average fifteen weeks after the operation, and there was no reduction loss. The arc of motion of the knee joint at the latest follow-up was 132 degrees on average. Average of Knee Society Score was 85 and UCLA activity scale was decreased from 9.6 points preoperatively to 5.7 points postoperatively. CONCLUSION: The treatment of Shatzker type 6 tibia plateau fracture using the lateral and posteromedial dual approach and dual plating have shown clinically preferable results of excellent recovery of joint motion and good knee society score by early range of motion exercise after firm fixation. However, it was high energy injury, so the sports activity of patients was significantly decreased.

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Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes
Seung Min Ryu, Han Seok Yang, Oog Jin Shon
Knee Surgery and Related Research.2018; 30(3): 261. CrossRef
Medial Minimally Invasive Percutaneous Plate Osteosynthesis in Proximal Tibial Comminuted Fractures
Jae-Ang Sim, Kwang-Hui Kim, Yong-Seuk Lee, Sang-Jin Lee, Beom-Koo Lee
Journal of the Korean Orthopaedic Association.2014; 49(4): 278. CrossRef
Current Concepts in Management of Tibia Plateau Fracture
Sang Hak Lee, Kang-Il Kim
Journal of the Korean Fracture Society.2014; 27(3): 245. CrossRef

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Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures: Jae Sung Lee, Yong Beom Park, Han Jun Lee; J Korean Fract Soc 2008;21(2):124-129. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.124

Abstract PDF: PURPOSE
To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation.
MATERIALS AND METHODS
We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test.
RESULTS
There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score.
CONCLUSION
The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.

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Evaluation of the Patterns of Fractures and the Soft Tissue Injury Using MRI in Tibial Plateau Fractures: Ji Yong Chun, Hee Gon Park, Sung Su Hwang; J Korean Fract Soc 2007;20(4):302-308. Published online October 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.4.302

Abstract PDF

PURPOSE
To compare information about fracture type in MRI with simple radiograph in tibial plateau fractures and evaluate tibial plateau fractures type and accompanying soft tissue injury, and evaluate usefulness of MRI in tibial plateau fractures.
MATERIALS AND METHODS
Compared MRI with simple radiograph about Schatzker classification, depression of articular surface and displacement of bone fragment from the 68 examples who checked MRI and we evaluated soft tissue injury around knee joint.
RESULTS
There were 7 examples of Schatzker type change after MRI check. Average depression of articular surface in simple radiograph was 2.93 mm and 4.28 mm in MRI. It increased by 1.35 mm and it was meaningful statistically (p<0.05). There was no significant difference between MRI and simple radiograph of displaced bone fragment (p=0.168). There were 58 (85.3%) cases of soft tissue injury in MRI.
CONCLUSION
MRI can find additional fracture line or articular depression that can't be found in simple radiograph and gives more information about articular depression and soft tissue that is useful in surgical plans. I think preoperative MRI is necessary to better treatment of fracture & treatment of periarticular soft tissue injury in tibial plateau fracture.

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The Use of Fresh Frozen Allogenic Bone Graft in the Impacted Tibial Plateau Fractures
Yeung Jin Kim, Soo Uk Chae, Jung Hwan Yang, Ji Wan Lee, Dae Han Wi, Duk Hwa Choi
Journal of the Korean Fracture Society.2010; 23(1): 26. CrossRef

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Operative Treatment of Proximal Tibial Plateau Fractures through Lateral Submeniscal Approach: Hyug Su An, Se Ang Chang, Jun Woo Park, Jin Seok Lee, Hun Ho Bang; J Korean Fract Soc 2004;17(3):237-242. Published online July 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.3.237

Abstract PDF: PURPOSE
The purpose of this study was conducted to evaluate the clinical results of proximal tibial plateau fractures treated with open reduction and internal fixation through the lateral submeniscal approach and allowed early motion of the knee and to evaluate the effectiveness of the approach.
MATERIALS AND METHODS
From January 1998 to December 2002, fifty four patients who underwent open reduction through the lateral submeniscal approach for proximal tibia plateau fracture and had a follow-up more than one year were included in this study. Clinical results were evaluated by postoperative radiographs taken at the last follow-up and Porter's assessment method.
RESULTS
Anatomical reduction was achieved under direct vision through the submeniscal approach in most of the cases in this study. The postoperative radiographs showed anatomical reduction in 32 cases (59%) and adequate reduction with displacement within 2 mm in 20 cases (37%). The clinical evaluation by Porter's assessment method revealed that 49 cases (91%) were acceptable results of excellent or good at the final follow-up CONCLUSION: This study indicates that open reduction and internal fixation through the lateral submeniscal approach can be a good option for proximal tibia plateau fractures because it allows accurate reduction of the articular fractures, which is confirmed directly during operation, identification and repair of associated soft tissue injuries are facilitated, sufficient bone graft and stable fixation of the articular fragments under direct vision allow early motion of the knee.

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The Efficacy of MRI in Tibial Plateau Fractures: Hyoun Oh Cho, Kyoung Duck Kwak, Dae Hwan Lim, Sang Min Ahn, Kyung Ku Kang; J Korean Fract Soc 2004;17(2):122-132. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.122

Abstract PDF

PURPOSE
To analysis the efficacy of MRI in assessing fracture configuration and frequency of associated soft tissue injuries in tibial plateau fractures.
MATERIALS AND METHODS
In the plain films and MRI of 47 cases with tibial plateau fractures,every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI.
RESULTS
MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragments. Fracture classifications were changed in 12 cases. Especially in Schatzker VI cases, articular step off over 2 mm and articular fragments over 2X2 cm were revealed in detail by MRI. Evidence of internal derangement of the knee was found in 38 (80.8%) cases.
CONCLUSION
Most of the cases with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.

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Evaluation of the Patterns of Fractures and the Soft Tissue Injury Using MRI in Tibial Plateau Fractures
Ji-Yong Chun, Hee-Gon Park, Sung-Su Hwang
Journal of the Korean Fracture Society.2007; 20(4): 302. CrossRef

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Results of Surgical Treatment in Schatzker Type VI Tibial Plateau Fracture: Kyung Jin Song, Kwang Bok Lee, Seung Jin Moon, Joo Hong Lee; J Korean Fract Soc 2004;17(1):32-37. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.32

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the factors influencing the results for the treatment of the Schatzker type VI tibial plateau fractures.
MATERIALS AND METHODS
Twenty-two cases of the 21 patients in Schatzker type VI tibial plateau fractures were analyzed. Treatment results were analyzed according to the type of fracture (open vs closed), method of operative treatment, angulation more than 5 degree and status of infection. The functional results was evaluated by Hohl's functional criteria. Student t-test was used for the statistical analysis.
RESULTS
Functional outcome demonstrated 5 excellent, 8 good, 6 fair and 3 poor results. There was no significant difference in the treatment results between type of fracture, method of operative treatment and status of infection. Among 9 cases with angular deformity of more than 5 degree, 2 showed excellent or good result and 7 showed fair or poor result (p<0.05). There was no significant difference between rate of postoperative infection and the mean period of the clinical bone union (p=0.66).
CONCLUSION
Accurate anatomical reduction and rigid fixation is essential for the treatment of Schatzker type VI tibial plateau fractures for the prevention of the angular deformity. And early weight bearing exercise should be controlled for the prevention of loss of reduction and loss of alignment leading to angular deformity.

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Lateral Submeniscal Approach in the Treatment of Tibial Condyle Fracture: Weon Yoo Kim, Jin Young Kim, Woo Sung Choi, Yong Hwan Kim, Bum Sung Lee, Young Mo Kim, Chang Whan Han; J Korean Soc Fract 2003;16(4):496-503. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.496

Abstract PDF: PURPOSE
To evaluate the radiologic and functional results of treatment in proximal tibial plateau fracture using lateral submeniscal approach, which is a relatively minimally invasive approach to tibial condylar articular surface.
MATERIALS AND METHODS
Twenty three cases of tibial plateau fracture which treated with submeniscal approach were analyzed with one year follow up. The results were evaluated by immediate postoperative radiographic and Hohl's clinical evaluation.
RESULTS
Tibial articular surface could be in operation field and the articular surface could be restored the anatomically by elevating the depressed articular surface and bone graft to the empty space. The postoperative radiography showed that most cases (91%) could be reduced adequately (within 2 mm). The clinical evaluation by Hohl's criteria revealed excellent 7 cases (30%), good 12 cases (52%), fair 3 cases (13%), and one poor case (4%).
CONCLUSION
Submeniscal approach can identify the articular surface and intraarticular soft tissues with minimal incision, and allows anatomical reduction, sufficient bone graft, rigid plate fixation and soft tissue treatment, therefore it is one of the good approach in treatment of proximal tibial plateau fracture.

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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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The results of Operative Treatment in the Proximal Tibial Plateau Fracture: Kyung Jin Song, Keun Ho Yang, Joo Hong Lee; J Korean Soc Fract 2002;15(4):489-496. Published online October 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.4.489

Abstract PDF: INTRODUCTION: The purpose of this study was to analyze the results, prognosis and complications in the treatment of proximal tibia plateau fractures, and to suggest the guideline for the proper management in the difficult cases of tibial plateau fractures.
MATERIALS AND METHODS
We have analyzed 27 cases, which surgically treated during recent five years with average 36.6 months follow-up. Patients ranged in age from 24 to 83 years at the time of hospitalization, consisting of 19 males(70.4%) and 8 females(29.6%). The type of fracture by Schatzker classification revealed in type I 3 cases(11.1%), type II 1 case(3.7%), type III 0 case(0%), type IV 3 cases(11.1%), type V 1 case(3.7%) and type VI 19 cases(70.4%). The associated injury occurred in 22 cases(81.5%), most of them were ipsilateral fibular, ipsilateral femoral and radioulnar fractures. The results were evaluated by Blokker 's criteria.
RESULTS
Screw fixation was done in 4 cases(18%) and plate fixation in 23 cases(85.2%), and bone grafting was done in 10 cases(37.0%). There were 10 postoperative complications with 3 cases of knee ankyosis, 3 cases of angular deformity, 3 cases of infection, and 1 case of traumatic arthritis. According to Blokker 's criteria, 22 cases(81.5%) had satisfactory results.
CONCLUSIONS
Accurate anatomical reduction and rigid internal fixation of the proximal tibial plateau fracture enabled early motion and normalization of injured soft tissues, and also provided functional improvement of the knee.

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Comparison of degrees of Depression Between Simple X-ray and MRI in Tibial Plateau Fracture: S W Suh, H C Lim, C Y Huh, W N Moon, D Park, M P Hong; J Korean Soc Fract 2002;15(2):146-151. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.146

Abstract PDF

PURPOSE
The purpose is to analyze the efficacy of the MR images in the diagnosis and the treatment of the tibial plateau fracture, by comparing the amount of depression in the plain radiograph and in the MR images.
MATERIALS AND METHODS
Both the MRI and the plain radiograph were performed in 14 patients from 1997 to March 2001. The Schatzker-fracture type and the amount of joint depression were measured and compared in the plain radiograph and the MR images.
RESULT
In the Schatzker's classification, both type I and II were largest in number. The average amount of joint depression was measured as 1.8 mm by plain radiograph and 5.5 mm by MRI, so the difference was measured as 3.7 mm.
CONCLUSION
In some cases the joint depressions were more than 3 mm by measuring in the MRI, even though the amount of joint depressions were much less by measuring in the plain radiograph. After measuring with MRI, the indication of the surgery may be expanded. In conclusion, as MRI in the tibial palteau fractures can give precise information of the amount and the position, it may help the prediction of the surgical indication and prognosis.

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Investigation Records of Each Tools Including ‘Nine Classical Acupuncture’ in Korean Classical Historical Books and Medical Books: A Study Based on an Electronic Database in Korea
Hongmin Chu, Jaehoon Choi, Hyocheong Chae, Joohyun Lee, Myungseok Ryu
Journal of Korean Medical Society of Acupotomology.2022; 6(1): 8. CrossRef

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The Biomechanics of Hybrid External Fixator: The Effect of Periarticular Half Pin on Frame Stiffness: Jong Keon Oh, Duk Young Jung, In Su Kim; J Korean Soc Fract 2002;15(2):114-122. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.114

Abstract PDF: OBJECTIVES
The purpose of this study was to identify the biomechanical effect of periarticular half pin in the hybrid external fixator.
METHODS
Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Seven frame configurations were tested : a four-ring Ilizarov frame, a hybrid frame with three wires on peri-articular fragment, hybrid frames with wires and half pins on peri-articular fragment by four different configurations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A materials testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The overall stiffness of the hybrid frame was increased up to 30% by replacing a coronal tension wire with a half pin placed on the sagittal plane. The hybrid frame constructed with two wires and a half pin on the sagittal plane of the periarticular fragment showed overall stiffness compatible with that of multi-level peri-articular fixation frame.
CONCLUSION
Our results show that the half pin placed on the periarticular fragment can be a effective tool to increase the stiffness of hybrid external fixators in this periarticular tibia fracture model.

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Operative Treatment of Tibial Plateau Fractures - Analysis of the factors affecting to the clincal results: Byeong Yeon Seong, Wan Soo Park, Sang Yul Shin, Yuen Ki Woo, Taek Geon Lee, Man Jae Park, Seung Ki Lee; J Korean Soc Fract 2002;15(1):87-96. Published online January 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.1.87

Abstract PDF: PURPOSE
The purpose of this study was to evaluate the relationship between variable factors and clinical results following the operative treatment of the tibial plateau fractures.
MATERIALS AND METHODS
The clinical and radiological analysis was performed on 29 cases of the tibial plateau fractures who had been treated with operative treatment and followed up for more than 1 year from January 1991 to December 1997. The analysis of clinical results was performed dividing into age, cause of injury, fracture type of Schatzker classification, associated soft tissue injury and method of operative treatment.
RESULTS
18 of 19 cases that were ranged of ages between 30 years and 59 years showed good clinical results as criteria of Blokker. Schatzker type II was noted 11 cases(37.9%) as most common. 13 of 14 cases of the type I,II and III, were showed good clinical results, compare to 10 of 15 cases of the type IV,Vand VI. 12 of 18 cases which were related with associated soft tissue injuries, were showed good clinical results.
CONCLUSION
We could expect good clinical results if early knee joint mobilization following open reduction and rigid internal fixation could be obtained. Factors affecting clinical results are age, type of fracture, associated soft tissue injuries. Bad clinical results were related with young age group under 30 and over 60, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.

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The Biomechanics of Hybrid External Fixator: Effectiveness of Bar to Ring Connection: Jong Keon Oh, Duk Young Jung, Seong Yong Yoon; J Korean Soc Fract 2001;14(4):783-791. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.783

Abstract PDF: OBJECTIVES
The biomechanical effects of bar to ring connection in a hybrid external fixator have not yet been clearly identified. The purpose of this study was to identify the biomechanical effects of bar to ring augmentation in the hybrid external fixator.
METHODS
Simulated tibial plateau fractures were created using a polyvinylchloride pipe. Groups of simulated periarticular tibia fractures were stabilized with one of six different external fixation constructs with components from one manufacturer. Six frame configurations were tested: a four-ring Ilizarov frame, a hybrid frame without bar to ring augmentation, hybrid frames with three different bar to ring augmentations, a hybrid frame constructed with multiple levels of fixation in the periarticular fragment. A material testing machine was used to apply pure compression, anterior and posterior bending, medial and lateral bending, and torsion. Stiffness values were calculated from the load deformation and torque angle curves RESULTS: The four-ring Ilizarov fixator was the stiffest in all modes of testing. Frame augmentation with three different types of bar-to-ring connection did increase stiffness in all modes of testing. No statistical difference was found between the stiffness of the frames with three different types of bar to ring augmentations. The stiffness of a hybrid frame constructed with multiple levels of fixation in the periarticular fragment was comparable to that of the fixators with bar to ring augmentation.
CONCLUSION
Our results show that the bar to ring augmentation increases the overall stiffness of hybrid external fixators in this periarticular tibia fracture model by 27-76%.

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Operative Treatment of the Type I and II Tibial Plateau Fracture: Jong Woong Park, Sung Kon Kim, Jung Ho Park, Joon Seok Hong, Jae Hun Kim; J Korean Soc Fract 2001;14(2):298-304. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.298

Abstract PDF: PURPOSE
To know the functional and radiologic results of the operative treatment for the type I and II tibial plateau fractures according to the methods of internal fixations.
MATERIALS AND METHODS
Twenty-six patients, who had been treated with open reduction and internal fixation for the type 1 or 2 tibial plateau fractures were evaluated. Twelve cases of type 1 fractures were fixated with 1 lag screw in 5, 2 lag screws in 4 and buttress plate in 3. Fourteen cases of type 2 fractures were fixated with 1 lag screw in 4, 2 lag screws in 6 and buttress plate in 4. The criteria of Hohl and Porter was used for the evaluation of the clinical and radiological results.
RESULTS
There was no significant difference in the clinical result in type 1 and 2 tibial plateau fractures according to the methods of fixations. And the radiological results were not significantly different in both of type 1 and 2 fractures.
CONCLUSION
If the anatomical reduction of the articular surface can be achieved, the methods of fixation for the type 1 and 2 tibial plateau fractures do not affect the final clinical and radiological results.

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Treatment of Tibial Plateau Fractures by Cannulated screw Fixation: Hyung Ku Yoon, Ho Seung Jeon, Kye Nam Cho, Seung Ju Jeon, Kang Woo Chung; J Korean Soc Fract 2001;14(1):73-78. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.73

Abstract PDF: PURPOSE
The results of treatment of tibial plateau fractures by extensive soft tissue exposure were less satisfactory even if anatomical reduction was achieved. The purpose of this study is to assess the functional and radiological results of the treatment of tibial plateau fractures by cannulated screw fixation to decrease soft tissue injury and operation time.
MATERIALS AND METHODS
From January 1996 to February 2000, 19 patients were treated by limited open reduction and internal fixation by cannulated screw. According to scoring of Rasmussen, the functional results were rated.
RESULTS
In all cases, Bony union was obtained and according to scoring of Rasmussen, excellent in 1 case, good in 14, fair in 4 cases. There were 2 cases of limitation of joint motion and 2 cases of persistant pain as sequale.
CONCLUSION
We considered that if accurate preoperative evaluation was done, Cannulated screw fixaction was easier and faster method than other methods for treatment of tibial plateau fractures.

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Injury of Lateral Meniscus Associated with Tibia Plateau Fracture: Young Bok Jung, Suk Kee Tae, Dong Lyul Yang, Jae Sung Lee, Jung Il Lim; J Korean Soc Fract 2001;14(1):60-65. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.60

Abstract PDF: PURPOSE
To analyse the frequency of soft tissue injuries associated with tibial plateau fracture through arthoscopy and demonstrate the pattern and treatment of lateral meniscal tear which is the most frequently concomitant injury. MATERIAL AND METHOD: We evaluated the charts, X-rays and arthoscopic records of the 27 patients who had been diagnosed as tibial plateau fracture and received the arthoscopic examination or arthoscopic assisted operative management and analysed the injury pattern, association of schatzker classification and treatment of the 9 patients who had been concomitant with lateral meniscal tear.
RESULT
In our cases, lateral meniscus tear was the most common among the soft tissue injury it was revealed that a longitudinal tear at the peripheral area was shown in 8 cases, which were treated with meniscal repair and a radial tear of the central area in l cases, treated with partial menisectomy.
CONCLUSION
Lateral meniscus injury is one of the most frequently concomitant with tibial plateau fracture, In those cases, arthroscopic meniscal repair would be helpful for better prognosis.

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AMRI Study of Associated Soft Tissue Injury in Tibial Plateau Fractures: Jang Suk Choi, Young Chang Kim, Sung Suk Seo, Ki Chan Ahn, Chang Sub Lee, Jae Sang Choi; J Korean Soc Fract 2000;13(3):501-506. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.501

Abstract PDF: Tibial plateau fractures can occur concomitent with injuries to the collateral, cruciate ligament and mensci. The purpose of this article is to demonstrate the frequency of soft tissue injuries associated with tibial plateau fractures and analyze the pattern of fracture more accurately by magnetic resonance imaging(MRI). Thirty one plateau fractures were evaluated in this study. MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragment. There was a 71%(22 of 31) frequency of associated soft tissue injuries in this series of tibial plateau fractures. The medial collateral ligaments were injured in 32.3%(10 of 31), the anterior cruciate ligaments in 29%(9 of 31), the posterior cruciated ligament in 22.5%(7 of 31), the lateral collateral ligament in 19.4%(6 of 31), and the menisci in 39%(12of 31). Schatzker type II and IV fracture patterns were associated with the highest frequency of soft tissure injuries. Medial collateral ligament injuries were most commonly associated with Schatzker type II fracture patterns. Menisci were most commonly injured with Schazker type IV fracture patterns. Most of the patients with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatement plan.

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Operative Treaeent of Hohl II, III Plateau Fracture by Small Incision and Bone Window: Jin Woo Kwon, Kyoung Tae Sohn, Sung Ho Shin, Woo Se Lee, Won Ho Jo, Jae Il Kim; J Korean Soc Fract 1999;12(3):593-600. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.593

Abstract PDF: Severely depressed plateau fractures, especially Hohl I, III, can not be reduced by ligamentotaxis and require elevation through a cortical window, bone grafting, and fixation with either cancellous screws or a buttress plate. But traditional long lateral parapatellar incision and plate fixation method caused frequent wound dehiscence and deep infection. Thus to reduce the soft tissue problem we treated Hohl II, III plateau fractures by small anterolateral L-shaped incision, submeniscal exposure, reduction of depressed plateau and bone graft through bone window, and then cancellous screws fixation beneath the subchondral bone of elevated plateau. We anayzes 22 cases with Hohl II, III plateau fractures, which were treated by these method from February 1990 to December 1997 and followed more than 1 year. Males were 17, and females were 5. Average age of patients was 44.7 years. The most common cause of injury was traffic accidents(17 cases), and fracture type according to the Hohl classification was 14 cases of type II, 8 of type III. The associated injuries were 18 cases of meniscus tear, 13 of ligament injury(6 ACL, 7 MCL). The clinical results by Blokkers criteria were satisfactory 19 cases(86.3%) and unsatisfactory 3 cases(13.7%). We concluded that this method has following advantages; relatively firm fracture fixation, short operation time, low soft tissue problem.

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Treatment of High-Energy Tibial Plateau Fracture: A comparison of External Fixation with Limited Internal Fixation to Plate and Screw Fixation: Suk Woong Yoon, Tae Sung Hwang, Byoung Gue Park; J Korean Soc Fract 1998;11(4):769-777. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.769

Abstract PDF: High energy tibial plateau fractures are associated with wevere articular depression, separation of both condyles, diaphyseal comminution and dissociation & loss of integrity of the soft tissue envelop. Thus it is very difficult to treat these fractures satisfactorily and severe complications may be developed. Authors carried out plate and screw fixation in 11 patients and external fixation(Ilizarov external fixator) with limited internal fixation in 8 patientsl who sustained high-energy tibial plateau fracture between Jan. 1992 and Feb. 1996. We compared the operative results of plate and screw fixation and external fixation with limited internal fixation in high-energy tibial plateau fractures which was follow up from 12months to 28months. The results were as follows; 1. The complications such as limitation of knee motion(3 cases), traumatic arthritis(1 case), angular deformity(2 cases), superficial infection(2 cases), deep infection(1 case), instability(1 case) were observed in plate fixation group. Limitation of knee motion(1 case), traumatic arthritis(1 case), delayed union(1 case) were developed in external fixation group. 2. According to Blokker's criteria, 6 cases(55%) among 11cases of plate and screw fixation group and 5 cases(63%) among 8 cases of Ilizarov external fixator group had satisfactory results. Ilizarov external fixation with limited internal fixation is useful method of treatment for high-energy tibial plateau fractures when extensive dissection and internal fixation are contraindicated due to comminution at the fracture site and compromise of the soft tissue.

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A Clinical study of the Tibial Plateau Fracture: Hyung Seok Kim, Ki do Hong, Sung Sik Ha, Beom Soo Kim; J Korean Soc Fract 1998;11(3):597-604. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.597

Abstract PDF

The tibial plateau fracture often produce some disabilities of the knee joint because it is the intraarticular fracture and often associated with soft tissue, ligament and meniscal injury. The authors analyzed 42 cases of the Tibial Plateau fractures, which were treated at the department of orthopaedic surgery, Seoul Adventist Hospital from 1992 to 1997, to know the releationship between the type of fracture, the methods of treatment, and the results. The results were summerized as follows; 1. The most common fracture type by Schatzker classification was type I(18 case 42.9%). 2. Sixteen cases among of 42 cases were treated with conservative treatment, and 26 cases were treated with operative method 3. The clinical result according to Blokker method, acceptable were 34 cases (81.0%) and unacceptable were 8 cases (19.0%) 4. The complications were limitation of range of motion(4 case), peroneal nerve palsy(2 case), posttraumatic arthritis(1 case), wound infection(1 case).

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Coating and Intergrowth of NaX Molecular Sieve Films on Porous Ceramic Paper for Membranes
Ik Jin Kim, Hae Jin Lee
Key Engineering Materials.2007; 280-283: 891. CrossRef
Effects of Seeding on Large Crystal Growth of NaX Zeolite by Continuous Crystallisation
Ik Jin Kim, Hae Jin Lee, Panagiotis Tsiakaras
Key Engineering Materials.2007; 280-283: 861. CrossRef

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Surgical Treatment of Tibial Plateau Fracture: Validity of Arthroscopy: Shin Kang Cho, Jung Dae Oh, Young Sik Lee, Jin Tae Choi, Gyeong Hin Lim; J Korean Soc Fract 1997;10(4):832-842. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.832

Abstract PDF

Twenty tibial plateau fractures were surgically treated by means of the double images of the arthroscopy and the image intensifier. The purpose of this attempt was (1) obtaining more anatomical reduction of articular margin, (2) preventing knee joint from the surgical dissection and (3) simultaneous diagnosis & management of the combined meniscus and ligament injuries. Three aims of this study are searching for (1) the indications of the arthroscopic surgery for the libial plateau fractures, (2) the techniques of the arthroscopic surgery for reduction and fixation and (3) the techniques for reducing the risk of the arthroscopic surgery. As a result, we can obtain more anatomical reduction and excellent or good functional knee score after follow-up study of a mean of 1 year and 9 months. There is no complication with regard to arthroscopic surgery. But anatomical reduction of the bicondyle fractures with severe articular and metaphyseal comminution was technically difficult. So, the other technique as if open reduction will be needed.

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau
Juhan Kim, Dong Hwi Kim, Jae-Hwan Lim, Hyunwoong Jang, Young Wook Kim
Journal of the Korean Orthopaedic Association.2019; 54(3): 227. CrossRef
Treatment of Shatzker Type VI Tibia Plateau Fracture Using Lateral and Posteromedial Dual Incision Approach and Dual Plating
In-Jung Chae, Sang-Won Park, Soon-Hyuck Lee, Won Noh, Ho-Joong Kim, Seung-Beom Hahn
Journal of the Korean Fracture Society.2009; 22(4): 252. CrossRef

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Results of Operative Treatment in Fracture of the Proximal Tibial Plateau: Yong yeun Kim, Dong Chul Lee, Jong Chul Ahn; J Korean Soc Fract 1997;10(4):823-831. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.823

Abstract PDF

The tibial plateau fractures commonly result from high energy trauma such as traffic accidents or falls, and it is can produce the disability of the knee joint because it is frequently accompanied by the soft tissue injury such as ligaments and menisci. Even if accurate anatomical reduction and rigid internal fixation with early motion can decrease the complications, recent study show unacceptable results from 20 to 40 persents of cases. We have analysed 44 cases of tibial condylar fracture which were treated with operative method at Yeungnam University Hospital from Feb. 1990 to Apr. 1996. The results were as follows : 1. The type of fracture by Schatzker classification revealed in type 17 cases(16%) type II 4 cases (9%), the III 8 cases(18%), type IV 5 cases(11%), type V 13 cases(30%), type VI 7 cases(16%), and the main causes of injury were traffic accident(35 cases;80%), and fall(6 cases). The associated injury occured in 30 cases(68%) . Half of them (57%) were ipsilateral fibular fracture in 9 cases, ipsilateral patellar fracture in 8 cases, and ipsilateral femoral fracture in 8 cases. 2. The Clinical evaluation by Hohl criteria revealed in 76.8 scores fair in average in 44 cases, those were excellent in 2 cases(5%), good in 27 cases(62%) and poor in 5 cases(11%). The Subjective evaluation of the patients were more than good in 13 cases(29%), and less than fair in 31 cases (71%). The clinical averge score according to the type of fracture by Hohl evaluation were 79 in type I, 81 in type II, 81 in type III, 74 in type IV, 84 in type V and 72 in type VI. 3. The clinical results according to the adeqacy of reduction of depressed joint surface after operation were more than good(score>80) when the anatomic or adequate reduction of joint surface were performed. 4. The most complication was limitation of motion in 11 cases(25%), the other complications showed angular deformity in 6 cases(15%), infection in 5 cases, traumatic arthritis in 5 cases, and pernoneal palsy in 4 cases.

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Second-look arthroscopy after surgical treatment of Schatzker type II plateau fractures through the lateral submeniscal approach
Han-Jun Lee, Ho-Joong Jung, Eui-Chan Chang, Jae-Sung Lee, Hyoung-Seok Jung
Archives of Orthopaedic and Trauma Surgery.2014; 134(4): 495. CrossRef
Dual Plate Fixation Compared with Hybrid External Fixator Application for Complex Tibial Plateau Fractures
Jae-Sung Lee, Yong-Beom Park, Han-Jun Lee
Journal of the Korean Fracture Society.2008; 21(2): 124. CrossRef

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Meniscal Incision to Approach for Lateral Tibial Plateau Fractures: Moon Gu Choi, Kee Haeng Lee, Chang Hoon Chung, Hyoung Min Kim, Hyun Jun Song; J Korean Soc Fract 1997;10(1):53-58. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.53

Abstract PDF: Exposure to the posterolateral comer of the tibial condyle was difficult due to narrow joint space and meniscus. From 1995. 1. to 1996. 4., the authors operatively reduced and internally fixed 9 cases of lateral tibial plateau fractures using lateral meniscal incision with minimal detatchment and retraction to improve visualization posterior aspect of articular cartilage Eight of the 9 cases were studied with three dimentional computerised tomogram and 1 case with roentgenographic tomogram to evaluate the shape, site and degree of comminution of the fracture fragments. ROM exercise was started at 4 weeks postopratively, manipulation under anesthesia were done in 3 cases at 12 weeks postoperatively. The follow up period was 13 months(from 8M to 1yr 11M). The results were obtained as follows, 1. Seven cases were split depression type, one was pure depression type and one was bicondylar type. 2. Articular depression were posterolateral aspect in 8 cases, and lateral aspect in one case. The degree of depression was average 15mm(range from 6mm to 22mm). 3. Six of the 9 cases had peripheral tear of the lateral meniscus. 4. Second look arthroscopy shows that the incision site of the meniscus were thinned but completely healed in 3 cases. 5. The ROM of the knee joint were 0 - over 135 in seven cases, 0 - 90 in one case, 30 - 60 in one case. This meniscal incision approach was one of the effective methods that provides exposure of the entire articula surface of the lateral tibial condyle easily to allow accureate eduction.

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Arthroscopic and Conventional Treatment of Lateral Tibial Plateau Fractures: Jung Man Kim, Chang Whan Han, Han Seok Son; J Korean Soc Fract 1996;9(3):647-655. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.647

Abstract PDF: The goals in the treatment of a tibial plateau fracture are to obtain a stable, aligned, mobile and painless joint and to minimize the risk of post-traumatic osteoarthritis. Most recently the management of tibial plateau fractures has been via arthroscopy. Proponents of arthroscopic techniques advocate their use not only to better visualize the surface of the tibia but also to evaluate the rest of the joint. This retrospective study compared the results of arthroscopic and conventional treatment of tibial plateau fractures from January 1988 through April 1995. Forty-seven knees of tibial plateau fractures were involved in this study. Sixteen of these patients were treated with arthroscopic reduction and autogenous bone graft with or without internal fixation, while the remaining 31 underwent open reduction, bone graft and internal fixation. The results are as follows: 1. The average time to full weight bearing was 10.2 weeks (range 7-14 weeks) in the arthroscopic group and 13.5 weeks(7.2-18 weeks) in the open reduction group. 2. The incidence of lateral meniscus tear was 56%(9/16) in the arthroscopic reduction group and 29%(9/31) in the open reduction group. 3. Flexion of at least 130 was obtained in 81%(13/16) of arthroscopic reduction group, while only Tabl 58%(16/31) in the open reduction group. Full extension was obtained in 93%(15/16) of arthroscopic reduction group, and in 83%(26/31) in the open reduction group. 4. Complications occurred more frequently in the open reduction group than in the arthroscopic reduction group.

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A Clinical Study of the Tibia Plateau Fracture: Hyung Seok Kim, Ki Do Hong, Sung Sik Ha, Dong Seok Kang, Jae Hyun Lim; J Korean Soc Fract 1994;7(1):105-112. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.105

Abstract PDF: The tibia plateau fractures are more common and severe than past decade because of increased traffic accident and industrial injury recently There are many argument about treatment of tibla plateau fractures, but the main goal of treatment Is to achived a stable, well-a-ligned, movable joint with minimum surface irregularities and with adequate soft tissue healing. The authors analyzed the 38 cases of the tibia plateau fractures treated at the Department of Orthopedic Surgery, Seoul Adventist Hospital from 1987 to 1992, to know the relationship between the type of fracture, treatment, and the results. The fallowing results were obtained. 1. The incidence Is more frequent in male and fifth decade was the most popular. 2. The most common cause of injury was traffic accident. 3. The most affrected site was left(26 cases) and lateral condyle(25 cases). 4. The most common fracture type acording to the Hohls classification were undisplaced and communited type of fractures. 5. 14 cases were treated with conservative method and 24 cases were treated with surgical method and 75% of patient which were treated with conservative, 86% of patient which were treated with surgical method, obtained satisfactory result according to Brokkers evaluation 6. The factors of poor results were as follow, communited fracture in Hohls classification, associated with severe other part of fracture, with severe soft tissue injury, or with ligament and meniscal injury.

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