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

Abstract

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.

Short oblique tibial shaft fracture combined with anterior cruciate ligament tear and posteromedial plateau fracture

“…Generally, it has been reported that a high incidence of internal knee injuries occurs in conjunction with ipsilateral femoral shaft fractures, but the incidence of knee injuries associated with tibial shaft fracture is lower than that of femoral shaft fracture [5][6][7][8][9]. Moreover, there has been no report on a case with ACL tear and depressed marginal fracture of the posteromedial tibial plateau combined with tibial shaft fracture like this case.…”

“…If any doubt exists on history of trauma and physical examination, additional radiographs such as both oblique views and plateau view as well as standard radiographs for ipsilateral knee are needed. Preoperative MRI can be quite useful and relatively accurate in assessing knee injuries such as meniscal and ligament injuries and revealing occult lesions not shown on radiographs [5][6][7][8]. However, we think that routine use of preoperative knee MRI in patients with high-energy mechanism fractures of tibial shaft is not necessary because concurrent knee injuries do not occur commonly, and the cost of MRI is relatively high [8].…”

“…Preoperative MRI can be quite useful and relatively accurate in assessing knee injuries such as meniscal and ligament injuries and revealing occult lesions not shown on radiographs [5][6][7][8]. However, we think that routine use of preoperative knee MRI in patients with high-energy mechanism fractures of tibial shaft is not necessary because concurrent knee injuries do not occur commonly, and the cost of MRI is relatively high [8]. Therefore, when soft tissue injuries and small osseous lesions around ipsilateral knee joint are strongly suspected on clinical examination and several radiographs, we recommend preoperative MRI and arthroscopy as a useful alternative when MRI is not possible.…”

Knee injuries associated with extraarticular tibial fractures and their impact on the clinical outcome of the patients: a prospective arthroscopic study

“…Because of the substantial force causing this type of fracture, concurrent ipsilateral intraarticular or/and extraarticular knee injuries are inevitable. Theoretically, the outcome of a tibial shaft fracture might be affected adversely by the presence of associated injuries 7. Therefore, identification of these injuries and determining their impact on the outcome of tibial shaft fractures was necessary.…”

A shortcoming and deficiency in “the prevalence of knee injuries ipsilateral to tibial shaft fractures and their impact on clinical outcome”

“…We read with interest the study of prevalence of knee injuries ipsilateral to tibial shaft fractures and their impact on clinical outcome [1] and wish to congratulate the authors on their excellent work. However, we have found there was a shortcoming and deficiency regarding the paper and wish to share them.…”