Arthroscopic Management of the Tibial Condylar Fractures

Park, In Heon; Lee, Kee Byoung; Park, Myung Ryool; Lee, Jin Young; Lee, Deuk Yong

Abstract

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and frequently accompanied by soft tissue injuries such as collateral ligaments, cruciate ligaments, and menisci present a variety of problems in treatment and prognosis. Slee, Apley, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually s form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommand anatomical reduction of the fracture as possible and early knee motion. The authors have treated 17 cases of tibial condylar fractures with arthroscopic management and extraarticular distal approach in the Department of Orthopedic surpery, Kang Dong Sacred Heart Hospital from Oct. 1986 to Jul. 1989. Of the above cases, 11 cases could be followed for a period of anywhere from 1 year to 31/2 years and analysed according to the cause, classification, treatment, and result. The following results were obtained from the analysis of 11 tibial condylar fractures. l. Of the 11 cases, 7 (63.6%) were male and 4 (36.4%) were female. 2. Of the 11 cases, 7 (63.6%) were due to traffic accident (5 pedestrians, 2 occupants) and 3 (27.3%) were due to fall from height. 3. Among 11 cases, 7 (63.6%) were associated with other injuries. 4. Bone graft was needed in 5 cases. 5. All were treated by arthroscopic management with anatomically and functionally good results. 6. By arthroscopic mangement, it was easy to find and treat the accompanying intraarticular lesion. 7. With early active and C.P.M. exercise, almost full range of motion was obtained in all cases.