The Tibial Condylar Fractures with Dissociation of Metaphysis and Diaphysis Treated by Surgical Methods

Suh, Jeung Tak; Lim, Kyoung Sam; Yoo, Chong Il

Abstract

The tibial plateau fracture involving the articular surface clinically is a very important injury which often can cause disabilities of the knee joint. Open reduction and internal fixation have been proposed as the optimal treatment of patient with Schatzker's type VI tibial plateau fracture because of the decrease in the functional impairment of the knee joint by allowing early motion. But the injury to the soft tissue is usually severe, which may lead to wound complications after internal fixation. Also delayed union, nonunion, and infection after such operation is not a few. Recently some authors have studied about the external fixation or minimal internal fixation as the treatment for tibial plateau fracture. The purpose of the current study was to compare the results of two different operative methods. The authors analyzed 9 cases of Schatzker's type VI tibial plateau fracture surgically treated at the Pusan National University Hospital from March 1991 to August 1994. The follow-up period ranged from 1 year to 4 year 7 months. The results were obtained as follows. 1. Of the 9 cases, 7 were male and 2 were female, the major population were the 6th and 7th decades. 2. The most common cause of this injury was traffic accident in 7 cases(78%). 3. About the fracture pattern, the most commom type was intercondylar fracture type in 5 cases(56%), the next one lateral condyle fracture type in 4 cases (44%). 4. Common associated injuries were ipsilateral fibula fracture in 8 cases(89%) and ipsilateral femur fracture in 4 cases(44%). 5. Six cases were treated by open reduction and internal fixation, and 3 cases were treated by external fixator. 6. According to Poster's criteria, the results were "Acceptable" in 7 cases(89%), "Unacceptable" in 2 cases(11%).