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
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
.