• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.2
• /
• pp.155-160
• /
• 2006

Purpose: To evaluate the results of meniscal repair and partial meniscectomy of lateral meniscus injury associated with tibial plateau fracture. Materials and Methods: Between February 1993 and August 2004, 24 cases (23 patients) of lateral meniscus tear with tibial plateau fracture were evaluated retrospectively. The most frequent type of tear was the longitudinal tear of the meniscocapsular junction (14 cases, 66.7%). All fractures were reduced under the control of arthroscopic and image intensifier. Arthroscopic repair of the longitudinal tear of the lateral meniscus or arthroscopic partial meniscectomy was performed. The final results were evaluated with the Ikeuchi criteria and Lysholm score. Results: At the final follow-up, the outcome was excellent in 12 cases (85.7%), good in 1 case (7.1%) and fair in 1 case (7.1%) among 14 cases of meniscal repair, and the excellent in 4 cases (66.7%) and good in 2 cases (33.3%) among 6 cases of partial meniscectomy according to the Ikeuchi criteria, There was a significant improvement of Lysholm score after surgery, 92.3 postoperatively compared with 56.6 preoperatively (p<0.0001, paired t-test). Conclusion: The fracture of the lateral tibial plateau did not seem to affect on the healing of the meniscus repair and partial meniscectomy.

• Journal of the Korean Arthroscopy Society
• /
• v.16 no.1
• /
• pp.9-16
• /
• 2012

Purpose: Tibial plateau fractures cause a variety of problems in the knee joint. The purpose of this study was to investigate the characteristics of the meniscus injuries in tibial plateau fracture arthroscopically. Materials and Methods: Thirty-three out of 39 consecutive patients diagnosed with tibial plateau fractures underwent arthroscopy between March 2007 and March 2010. According to Schatzker classification, there were 1 type I (3.3%), 19 type II (53.3%), 4 type III (13.3%), 2 type IV (6.6%), 2 type V (6.6%) and 5 type VI (20%) fracture patterns in 33 patients. Results: Twenty-five cases (75.8%) had lateral meniscus tears. There were 18 meniscal tears in 19 cases of Schatzker type II fractures (94.7%), 3 meniscal tears out of 4 cases of Schatzker type III fractures (75%) and 4 meniscal tears out of 5 cases of Schatzker type VI fractures (80%). The most commonly affected site (22/25) was the anterior horn of the lateral meniscus. Of the 25 documented meniscal tears, all but one were vertical longitudinal tear at meniscocapsular junction so most cases are amenable to arthroscopic repair. Conclusion: Arthroscopy for the meniscal injuries in tibial plateau fractures is a valuable diagnostic and treatment tool, we recommend arthroscopy in tibial plateau fracture.

• Journal of the Korean Arthroscopy Society
• /
• v.10 no.1
• /
• pp.53-60
• /
• 2006

Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

• Journal of the Korean Orthopaedic Association
• /
• v.54 no.3
• /
• pp.227-236
• /
• 2019

Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.

• Journal of Veterinary Clinics
• /
• v.34 no.1
• /
• pp.7-12
• /
• 2017

Twelve dogs weighing less than 10 kg underwent unilateral TTO to stabilize the stifle joint with cranial cruciate ligament rupture. Surgical findings, intra-operative and post-operative complications were recorded. Radiographic examinations were performed for 8 weeks following surgery. Postoperative outcome was evaluated using a visual analogue lameness scoring system. Mean preoperative PTA (the angle created by the intersection of the tibial plateau extrapolation line and the patellar tendon) was 103.8 degrees. Mean tibial wedge angle was 16.6 degrees. Mean postoperative PTA was 92.1 degrees. Intraoperatively, fracture through the caudal tibial cortex occurred in all dogs, through the distal tibial crest cortex in 2 dogs, through the lateral tibial cortex in 2 dogs and through the fibula in 1 dog. Four-week postoperative radiographs demonstrated evidence of progressive bone union at osteotomy site and complete unions were identified at 8 week in 10 dogs. All dogs were healed in 11 weeks. Most of dogs revealed weak lameness in 4 weeks and normal ambulation in 8 weeks postoperatively except for only one dog returned in 11 weeks. Despite frequent minor complication, it appears that the TTO is an alternative procedure for management of cranial cruciate ligament rupture in small breed dogs.

• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.163-169
• /
• 2013

Purpose: This study was conducted to confirm the anatomic conformity of the new periarticular locking plates designed by Zimmer on Korean adult bones and to identify the structures at risk during the application of these implants. Methods: The study was performed on the humerus, radius, and tibia of 10 adult cadavers(6 males and 4 females) procured from the cadaveric lab of our hospital. Anteroposterior (AP) and lateral X-rays were taken to confirm that the cadavers were free of any unusual lesions or anatomic variations. We used the 3.5-mm proximal humerus plate, 2.7-mm distal radius plate, 3.5- and 5.0-mm proximal tibia plates, and 3.5-mm distal tibia plate developed by Zimmer, Inc. (Zimmer periarticular locking plate). The longest plate from each group was used to confirm anatomical conformity. Standard approaches were used for each area, and soft tissue was retracted in order to pass the plate beneath the muscle. The position of the plate was confirmed using standard AP and lateral view X-rays. After this procedure had been completed, the region was dissected along the length of the implant to determine the conformity of the implant to bone and the penetrations of screws into the articular surface or violations of any vital structures, such as nerves, blood vessels, or tendons. Results: Excellent anatomical conformity was observed with Zimmer periarticular locking plates for Korean adults. The tibial nerve and the posterior tibial artery were found to be structures at risk when applying a distal tibial plate. Conclusion: Additional posterolateral fixation is recommended when dealing with cases of tibial plateau fracture when the fracture line extends to the posterolateral cortex. We recommend taking proper views using 10~15 degrees of internal rotation to ensure correct screw length and, thus, avoid penetration of vital structures and tendons.