Journal List > J Korean Orthop Assoc > v.26(4) > 1114957

Ahn, Bae, and Choi: Fractures of the Tibial Intercondylar Eminence

Abstract

We have experienced 20 cases of fractures of the tibial intercondylar eminence. The purpose of this paper is to report the effective management which can overcome the complications from this fracture such as anterior instability and extension limitation and will be good for improving knee joint motion. The average age of the patients was 25 years. The average follow-up period is 35 months. For the causes, 11 cases were from T.A., 2 cases from fall down, 2 cases from sports and 2 cases from others. 16 cases were fresh injuries which were whithin 3 weeks from trauma and 4 cases were old injuries more than 3weeks after trauma. According to Meyer and Mckeever classification, 3 cases belong to type I, 3 cases type II and 14 cases type III. Associated injuries were in order as following:6 cases of MCL injury, 3 cases of meniscus injury, 2 cases of PCL injury, one case of LCL injury and tibial fracture and fibular fracture take respectively, one case. For management, in case of the acute injury, cast immobilization was performed for type I and II (6 cases) and arthroscopic fixation was performed for type III (10 cases). In 4 cases of the old injury which were all type III, open reduction and internal fixation was performed because of extension limitation and anterior instability. We put the purpose of operation on the overcoming the extension limitation due to the nonunited bony fragment and correction of the anterior instability by repairing ACL. The indication of operation was principally as following:1. The type III injury, 2. In case associated with ligament injuty, 3. In the case that fragment can't be reduced with the non-operative method, 4. In case of non-union. In two cases, redudtion was obstructed by the meniscus interposed at the fracture site. The mean duration of cast immobilization was 36.5 days. The average flexion contracture after long term follow up was 3.4 deg. and the average flexion arc was 123 deg. As results of long term follow-up, 18 cases of the patients graded "Good" or "Fair". In conclusion, we can correct the extension limitation and anterior instability by selecting appropriate management method and early ambulation. Arthroscopic fixation was good method for improving knee joint motion because it makes early ambulation possible and reduced hospital day (13 days).

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