The prevalence of knee injuries ipsilateral to tibial shaft fractures and their impact on clinical outcome

被引：12

作者：

Guler F. ^{[1
]}

Kose O. ^{[1
]}

Erol B. ^{[2
]}

Turan A. ^{[1
]}

Koroglu M. ^{[2
]}

Akalin S. ^{[1
]}

机构：

[1] Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Kultur mah. 3805 Sk. Durukent Sit., F Blok Daire 22, Kepez, Antalya

[2] Department of Radiology, Antalya Education and Research Hospital, Antalya

来源：

European Journal of Orthopaedic Surgery & Traumatology | 2015年 / 25卷 / 1期

关键词：

Knee ligamentous injuries; Magnetic resonance imaging; Tibial shaft fracture;

D O I：

10.1007/s00590-014-1465-5

中图分类号：

学科分类号：

摘要：

Objective The purpose of this prospective study was to examine the prevalence of occult knee injuries in patients with ipsilateral tibial shaft fractures and determine their impact on clinical outcome. Materials and methods Preoperative knee MRI examination was performed in 41 patients (42 knees) with isolated tibial shaft fractures. Menisci, cruciate ligaments, collateral ligaments, extensor mechanism, osteochondral lesions, bone contusions and knee effusion were evaluated. All patients were treated with reamed and locked intramedullary tibial nailing without an additional surgical procedure for knee injuries. All patients were followed to at least fracture union and were evaluated with knee examination and Lysholm knee score. Results Of the 42 knees, 41 (97.6 %) showed at least one defined injury around the knee. There was only one patient who had totally normal knee MRI findings. One or more ligamentous injuries of the knee were identified in 35 (83.3 %) of the knees. Five patents (11.9 %) had medial meniscal tear in posterior horn. Extensor mechanism injuries were seen in two patients. Mild to marked joint effusion was observed in 35 (81 %) knees. Twenty-two knees demonstrated bone bruise; femoral condyle (n = 7), tibial plateau (n = 12), patella (n = 2) and fibular head (n = 1). No patients had osteochondral lesion. Patients were followed with a mean of 13.2 ± 3.6 (range 8-22) months. Clinical knee examination revealed Grade II (?) anterior drawer test in two patients. The mean Lysholm knee score was 99.1 ± 2.14 (range 91-100) at the final follow-up. Conclusions Ipsilateral intra-articular, extra-articular or combined knee injuries may occur at the time of injury with tibial shaft fractures. However, most of these injuries are not clinically relevant and heal without any sequel or remain asymptomatic late after fracture union. Routine use of preoperative knee MRI examination in patients with tibial shaft fractures is not necessary. © Springer-Verlag Berlin Heidelberg 2014.

引用

页码：141 / 148

页数：7

共 17 条

[11]

Tegner Y., Lysholm J., Rating systems in the evaluation of knee ligament injuries, Clin Orthop Relat Res, 198, pp. 43-49, (1985)

[12]

Hammer R., Tibial shaft fracture associated with silent isolated partial rupture of the anterior cruciate ligament, Arthroscopy, 1, 2, pp. 128-130, (1985)

[13]

Huang Y.H., Liu P.C., Chien S.H., Chou P.H., Lu C.C., Isolated posterior cruciate ligament injuries associated with closed tibial shaft fractures: A report of two cases, Arch Orthop Trauma Surg, 129, 7, pp. 895-899, (2009)

[14]

Chahal J., Dhotar H.S., Zahrai A., Whelan D.B., PCL reconstruction with the tibial inlay technique following intra-medullary nail fixation of an ipsilateral tibial shaft fracture: A treatment algorithm, Knee Surg Sports Traumatol Arthrosc, 18, 6, pp. 777-780, (2010)

[15]

Subhas N., Sakamoto F.A., Mariscalco M.W., Polster J.M., Obuchowski N.A., Jones M.H., Accuracy of MRI in the diagnosis of meniscal tears in older patients, AJR am J Roentgenol, 198, 6, pp. W575-W580, (2012)

[16]

Halinen J., Koivikko M., Lindahl J., Hirvensalo E., The efficacy of magnetic resonance imaging in acute multi-ligament injuries, Int Orthop, 33, 6, pp. 1733-1738, (2009)

[17]

Boden S.D., Davis D.O., Dina T.S., Stoller D.W., Brown S.D., Vailas J.C., Labropoulos P.A., A prospective and blinded investigation of magnetic resonance imaging of the knee. Abnormal findings in asymptomatic subjects, Clin Orthop Relat Res, 282, pp. 177-185, (1992)

← 1 2 →