Injuries to the posterolateral aspect of the knee accompanied by compression fracture of the anterior part of the medial tibial plateau

Citation
T. Chiba et al., Injuries to the posterolateral aspect of the knee accompanied by compression fracture of the anterior part of the medial tibial plateau, ARTHROSCOPY, 17(6), 2001, pp. 642-647
Citations number
11
Language
INGLESE
art.tipo
Editorial Material
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
ARTHROSCOPY
ISSN journal
0749-8063 → ACNP
Volume
17
Issue
6
Year of publication
2001
Pages
642 - 647
Database
ISI
SICI code
0749-8063(200107/08)17:6<642:ITTPAO>2.0.ZU;2-M
Abstract
We present 12 cases of patients with injury to the posterolateral aspect of the knee accompanied by a compression fracture of the anterior part of the medial tibial plateau. There were ii male patients and 1 female patient wi th an average age of 26 years (range, 17 to 44 years). There were 4 cases o f posterolateral rotatory instability and 8 cases of straight lateral insta bility of the knee. The size of the compression fracture was classified int o 2 types, small (8 cases) and large (4 cases). Although the mechanism of i njury was considered to be hyperextension and varus force, the pattern of c ruciate ligament injuries varied from case to case. The following 3 questio ns should be considered to determine which cruciate ligament is damaged: (1 ) Was the ipsilateral foot fixed to the ground? (2) Was forward inertia inv olved? (3) Was there a direct blow to the anteromedial aspect of the tibia or to the femur? Accompanied fractures of the medial tibial plateau were co nsidered to have been compressed by the medial femoral condyle. The size of the accompanying compression fracture varied; 7 of 8 cases with a small-ty pe fracture had posterior cruciate ligament injuries and 3 of 4 cases with a large-type fracture had anterior cruciate Ligament injuries. The size of the fracture is determined by which point of the medial tibial plateau touc hed the medial femoral condyle. We propose that a compression fracture of t he anterior part of the medial tibial plateau indicates a coexistent poster olateral aspect injury, and that especially a small compression fracture st rongly suggests an accompanying posterior cruciate ligament injury, as well .