Results of Operative Treatment in Fracture of the Proximal Tibial Plateau

Kim, Yong yeun; Lee, Dong Chul; Ahn, Jong Chul

Abstract

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.