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.
Classification ; Depression ; Knee Joint ; Magnetic Resonance Imaging* ; Soft Tissue Injuries*

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.
Classification ; Depression ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Soft Tissue Injuries

BACKGROUND: 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: According to Schatzker classification, 2 cases(6.9%) were type I, 11 cases(37.9%) were type II, 1 case(3.5%) was type III, 5 cases(17.2%) were type IV, 4 cases(13.8%) were type V, and 6 cases(20.7%) were type VI. In all cases, bony unions were obtained. According to Blokker evaluation, 23 cases(79.3%) of 29 cases were acceptable. CONCLUSION: We could expect good clinical results if early knee joint mobilization following minimal invasive open reduction and internal fixation could be obtained. Bad clinical results were related with young age group under 30, more than Schatzker classification type IV of high energy trauma and associated injury of anterior cruciated ligment or meniscus.
Classification ; Humans ; Knee Joint ; Soft Tissue Injuries ; Tibia

The necessity and superiority of the surgical operation on children with floating knee injury and the fracture union and complications were investigated. Twenty-eight children with floating knee injury were subjected to open reduction and internal fixation or external fixator. The patients were followed up for 18 months to 7 years. The curative effectiveness was scored by Karlstrom criteria. The results showed that no nonunion or deformity was found. The affected limb was 1.2 cm to 1.5 cm longer in 2 cases, 0.8 to 1.2 cm shorter in 3 cases than the contralateral. No severe dysfunction of knee joint occurred. The excellent-good rate was 92.8% and the curative rate 71.4% respectively. So for children whose age is older than 5 years, it's a good way to treat the fractures of femur and tibia with open reduction and internal fixation or external fixator. The method can be advantageous for the nursing care, early function recovery, shortening of the hospital stay and avoidance of severe complications.
Femoral Fractures/complications ; Femoral Fractures/*surgery ; Fracture Fixation ; Knee Injuries/classification ; Knee Injuries/etiology ; Knee Injuries/*surgery ; Tibial Fractures/complications ; Tibial Fractures/*surgery ; Treatment Outcome

The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the articular surface and the supporting metaphysis of a major weight bearing joint. This fracture frequently accompanies soft tissue injury such as ligaments and menisci. So it often produces disability of the knee joint. Of the tibial plateau fractures which had been treated by open reductions at Keimyung University Hospital between May 1971 and December 1981, the 28 cases that were followed for 1 year to 3 years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone with one or more of the following deformities as shown by roentgenograms: a compression greater than 6-8mm and a split greater than 5mm of the condyle. Anatomical considerations and a clinical end result study of the 28 fractures emphasize that the unacceptable results were from comminution of the fracture, associated soft tissue injury, osteoporosis, infection and other conditions that prevent early knee motion. Twenty-two cases (79 per cent) out of Twenty-eight revealed the rating of “ACCEPTABLE” according to Roberts criteria.
Classification ; Clinical Study ; Congenital Abnormalities ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoporosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

Classification of meniscal tear is necessary only for partial resection. In western countries many reports said that medial meniscal tear is commoner than that of lateral meniscus. Actually the reverse is true in Korea and in some other oriental countries, However there is no plausible explanation concerning this matter. In this report 250 knees of 240 patients were involved. We performed arthroscopic meniscectomy in all cases and we investigated the relationship between the pattern of tear and many possibly related factors. The follow-up period was 1–8 years, the ratio of male-female was 163:77, and the range of age was varied between 7 and 71 tears with the young and middle age groups being predominant. Right and left side ratio was 117:113 and the involvement of both knees was noted in 20 knees of 10 patients. The results were as follows: 1. The medial menisci were torn in 100 knees and was less than 142 lateral meniscal tear, with the ratio being 1:1.4. The tear of lateral meniscus was commoner in the age group of less than 30 years and the tear of medial meniscus was commoner in the age group older than 50 years whereas there was no difference in the age group of inbetween. 2. The commonest pattern of tear was longitudinal one including peripheral tear, that is 135 knees (54.0%), followed by complex tear, 50 knees (20.0%), oblique tear, 40 knees (16.0%), horizontal tear, 21 knees (8.4%) and lastly superior and inferior flap tear, 5 knees (2.0%). 3. The longitudinal tear was most prevalent in the age group of 20–40, whereas the complex tear was most prevalent in the age group of beyond 50 years (p<0.05). 4. The longitudinal tear was significantly prevalent in lateral menisci, the complex tear in medial menisci (p<0.05), whereas the transverse and oblique tear were not significantly prevalent in either meniscus (p>0.05). 5. In the longitudinal tear group, the tear occured most frequently in the midsubstance of posterior portion in the medial menisci without statistical significance (p>0.05) wereas the tear occurred most frequently in the periphery of the anterior portion in case of lateral menisci (p<0.05). 6. There were 37 discoid lateral menisci, with the longitudinal tear being the commonest. 7. Ground sports injuries occurred only in 34 knees (13.6%), with the longitudinal tear being significantly commoner than in the other injuries. From these results it would be suggested that although the discoid lateral meniscus has to be given much weight in the total meniscal injuries another explanation should be given concerning the prevalence of lateral meniscus tear compared to the medial meniscus tear and the prevalence of longitudinal tear.
Athletic Injuries ; Classification ; Follow-Up Studies ; Humans ; Knee ; Korea ; Menisci, Tibial ; Middle Aged ; Prevalence ; Tears

The fracture of the tibial condyle involving the articular surface can produce some disability of the knee joint because it is frequently accompanied by soft tissue injury to the ligaments and menisci. Accurate anatomical reduction and rigid internal fixation with early mobilization is known to provide good results. The authors analysed 50 cases of the fracture of the tibial condyle which were treated with recent method(anatomical reduction, rigid fixation and early joint motion) at the Dae Han Hospital from January, 1988 to May, 1993. The results were summerized as follows: 1. The associated injuries were ligamentous injury in 24 cases(48%), fibular fracture in 21 cases(42%), femur fracture in 7 cases(14%) and meniscal injury in 7 cases(14%). 2. According to Hohl's classification, the split compression type was most common in 17 cases(34%), and there were 14 comminuted type(28%), 8 local compression type(16%), 7 total condylar compression type(14%) and 4 split type(8%). 3. Method of internal fixation were plate & screw in 32 cases(64%), tibial bolt & screw in 18 cases(36%), bone graft in 31 cases(62%), ligament repair in 24 cases(48%) and menisectomy in 4 cases(8%). 4. The clinical result by Insall's criteria were excellent in 37 cases(74%), good in 8(16%), fair in 3(6%), poor in 2(4%) among 50 cases.
Classification ; Early Ambulation ; Femur ; Joints ; Knee Joint ; Ligaments ; Methods ; Soft Tissue Injuries ; Transplants

OBJECTIVES: To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. METHODS: Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). RESULTS: The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.63) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). CONCLUSIONS: Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery. In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.
Classification ; Diagnosis ; Education ; Female ; Humans ; Jogging ; Knee Injuries ; Knee* ; Logistic Models ; Occupations ; Osteoarthritis ; Osteoarthritis, Knee* ; Prevalence* ; Rheumatology ; Rural Population ; Self Care ; Smoke ; Smoking ; Swimming ; Workplace

The tibial condylar fractures involving the articular surface can produce some disability of the knee joint because it is frequently accompanied by soft tissue injury to the ligaments and menisci. Accurate anatomical reduction and rigid internal fixation with early motion is known to decrease the complications. During a period of 10 years, from January 1978 to December 1987, we treated 105 tibial condylar fractures at Severance Hospital. Of the above, 77 cases have been analyzed according to the classification, cause of injury, method of treatment, final result and complication. The 77 cases were classified as follows ; total condylar depression 17(22%), undisplaced 16 (21 %), split compression 16(21 %), comminuted 14 (18%), local compression 5 (7%), split 1 (1%) and others 8(10%). Among these, 59 cases revealed the result of “ACCEPTABLE” according to Porter's criteria. Of the conservative group, 86% obtained the rating of “ACCEPTABLE” and 67% of the operative group did as well. Possible complications include traumatic arthritis (9), limited motion (9), wound infection (6), instability (3), angular deformity (2), intraarticular loose body (2), nonunion (1) and myositis ossificans.
Arthritis ; Classification ; Clinical Study ; Congenital Abnormalities ; Depression ; Knee Joint ; Ligaments ; Methods ; Myositis Ossificans ; Soft Tissue Injuries ; Wound Infection

OBJECTIVE: The purpose of this study was to evaluate the diagnostic efficacy of using additional oblique coronal MRI of the knee for grading anterior cruciate ligament (ACL) graft injury after ligament reconstruction surgery. MATERIALS AND METHODS: We retrospectively reviewed 51 consecutive MR knee examinations of 48 patients who underwent both ACL reconstruction and follow-up arthroscopy. The MR examinations included the orthogonal axial, sagittal, coronal images and the oblique coronal T2-weighted images, which were oriented in parallel with the course of the femoral intercondylar roof. Two radiologists independently evaluated the status of the ACL grafts with using the routine knee MRI and then with adding the oblique coronal imaging. The severity of ACL graft injury was graded using a 3-point system from MR images as intact, partial tear or complete tear, and the results were compared with the arthroscopic results. Weighted kappa statistics were used to analyze the diagnostic accuracies of the knee MRI with and without the additional oblique coronal imaging. For each evaluation, the observers reported a confidence level for grading the ACL graft injuries in the two imaging groups. RESULTS: The weighted kappa values according to the routine knee MRI were 0.555 (reader 1) and 0.515 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.666 (reader 1) and 0.611 (reader 2). The mean confidence levels by each reader were significantly higher (p < 0.01, paired t-test) with the additional oblique coronal imaging than by using the routine knee MRI alone. CONCLUSION: The additional use of oblique coronal MRI of the knee improves both the diagnostic accuracy and confidence for grading ACL graft injury.
Adolescent ; Adult ; Anterior Cruciate Ligament/*injuries/*pathology/surgery ; Arthroscopy ; Female ; Humans ; Injury Severity Score ; Knee Injuries/*classification ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Retrospective Studies