A Clinical Study on Fractures of the Tibial Plateau
10.4055/jkoa.1980.15.1.94
- Author:
Jae Lim CHO
;
Kwang Suk LEE
;
Kwang Hoe KIM
;
Byung Kee KIM
- Publication Type:Original Article
- MeSH:
Anesthesia;
Classification;
Clinical Study;
Congenital Abnormalities;
Depression;
Extremities;
Fractures, Comminuted;
Fractures, Open;
Immobilization;
Joints;
Knee;
Tibia;
Traction;
Weight-Bearing
- From:The Journal of the Korean Orthopaedic Association
1980;15(1):94-103
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A tibial plateau fracture was first described in the literature by Thamhayn, in 1852. It is a fracture of the proximal end of the tibia, usually involving an articular surface. The fracture is regarded as serious as it involves a major weight bearing joint and loss of function results in a high percentage disability of the extremity. Of the tibial plateau fractures treated at Hanyang University Hospital between June 1972 and August 1979, the 44 cases that could be followed for three months to two years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone of or a combination of the following deformities as shown by roentgenograms: 1. a vertical depression in the plateau of greater than eight milimeters; 2. a horizontal displacement of the lateral or medial condyle of greater than four milimeters; 3. valgus or varus instability of the knee one or more milimeters in excess of that of the uninjured knee. Manipulation under anesthesia with skeletal traction is indicated in severe comminuted fracture that it is difficult to reduce with internal fixation, and open fracture that it is inevitable to delay operation. Plaster immobilization is indicated in the remaining situations except those of open reduction and skeletal traction. Anatomical considerations and a clinical end-result study of the 44 fractures emphasize the vulner-ability of the lateral tibial plateau to a valgus force on the extended knee. Among the 44 cases twenty-two (50 percent) were treated by plaster immobilization, 2 (4.5 percent) by skeletal traction, and 20 (45.5 percent) by operation. Thirty-nine cases (88.6 percent) out of 44 revealed the rating of “ACCEPTABLE” according to Hohl and Luck criteria.
