Tibial condylar fractures. A twenty-year follow-up.

Lansinger, Olle; Bergman, Bengt; Körner, L; Andersson, Gunnar

doi:10.2106/00004623-198668010-00003

Cited by 240 publications

(147 citation statements)

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“…We suppose that this finding may explain why some studies that did not address TKA patients or excluded them from further analysis reported that clinical results remained the same. [5,6,8] Half of the patients with no or minimal OA at the first FU in our study showed no deterioration of radiological OA at the second FU.…”

Section: Discussionmentioning

confidence: 48%

“…Lansinger et al presented the results of 102 tibial condylar fractures with a mean FU of 20 years (patients were part of a study by Rasmussen that had a mean FU length of 7.3 years). [6,7] The authors found no difference in clinical results of the shorter and longer FU. Rademakers et al performed examinations at one year and an average of 14 years after operated TPF and concluded that the one year FU adequately predicts long-term results.…”

Section: Introductionmentioning

confidence: 87%

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Radiographic and clinical results after surgically treated tibial plateau fractures at three and twenty two years postsurgery

Mattiassich¹,

Scheurecker³

et al. 2013

International Orthopaedics (SICOT)

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Purpose We examined the development of osteoarthritis (OA) and post-traumatic bone loss after surgery for tibial plateau fractures (TPF). Methods Patients who had participated in previous follow-up (FU) examinations after TPF and primary reduction and internal fixation were re-evaluated. At the first FU, a median of three years after the accident (short-term FU), the patients underwent functional assessments and standardised X-rays to grade radiological OA and post-traumatic bone loss. At the second FU, a median of 22 years after the accident (long-term FU), 30 patients were available. An identical protocol was applied, and additional investigations [Knee Injury and Osteoarthritis Outcome Score (KOOS) and magnetic resonance imaging (MRI) of the injured knee] were performed. Results When the subjective and objective results at first FU were compared with those of the second FU for the same patients, deterioration of symptoms, signs and radiological OA was noted; however, ten patients had no OA even after the long-term FU. Some patients developed post-traumatic bone loss. In 13 of 31 knees, there was little or no radiological evidence of bone loss at the second FU. Conclusions The short-term FU examination results after TPF have little prognostic value for the individual patient, as good results may deteriorate over the long run; however, there were some knees with no OA at the long-term FU. This is the first report focusing on post-traumatic bone loss after TPF.

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Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 87%

Radiographic and clinical results after surgically treated tibial plateau fractures at three and twenty two years postsurgery

Mattiassich¹,

Scheurecker³

et al. 2013

International Orthopaedics (SICOT)

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“…1 Lansinger reported 70% affecting the lateral condyle, 11% medial condyle and 19% bicondylar lesions. 12 Based on our study surgical methods give excellent to good results. Similar reports have been published by Chaix et al reported 86% good to excellent results by surgical means of treatment.…”

Section: Discussionmentioning

confidence: 66%

“…1 Lansinger reported 31% of the patients injured due to direct trauma, 33% due to fall from height and 45% were injured in road traffic accidents. 12 All the fractures in this study are classified according to Schatzker's classification system. Hence our findings differ from the findings in literature given below, the possible explanation could be poor safety precautions by citizens and weaker bone structure.…”

Section: Discussionmentioning

confidence: 99%

Various modalities of treatment of proximal tibial fractures: a prospective longitudinal study

Rabari¹,

Somanni²,

Prasad³

et al. 2017

Int J Res Orthop

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INTRODUCTIONTibial plateau fractures are one of the commonest intraarticular fractures. They result from indirect coronal or direct axial compressive forces. This makes about 1% of all fractures and 8% of the fractures in elderly.These fractures encompass many and varied fracture configurations that involve medial, lateral or both plateaus with varying degrees of articular depressions and displacements. Each fracture type has its own characteristic morphology and response to the treatment. It is essential to determine the force of injury since highenergy trauma is associated with considerable soft tissue and neurovascular damage. Apart from tibial plateau bony injury, meniscal tear and ligament injuries should also be assessed. ABSTRACTBackground: Tibial plateau fractures are one of the commonest intra-articular fractures. They result from indirect coronal or direct axial compressive forces. This makes about 1% of all fractures and 8% of the fractures in elderly. Nevertheless, tibial plateau fractures challenging remain because of their number, variety and complexity. With advancements the treatment of each fracture type is still not defined hence we have taken up this study to analyze various fracture patterns and its outcome. Methods: The study includes 40 patients having the fractures of the proximal tibial metaphyseal; metaphyseodiaphyseal with or without intra-articular extension (including upper third fractures of tibia), closed fractures, fractures with Open grade-I wounds (Gustillo Anderson Classification).The study excludes compound fractures having grade II and III (Gustillo Anderson) and Paediatric patients. The treatment method was based on the type of fracture, the amount of displacement , the amount of depression and surrounding skin condition of the tibial plateau. We used the Schatzker classification because it is closest to describing the specific fracture type and it is easy to apply. Results: In this study there were 40 patients with mean age of 39.18 (median 38.5 and min -max 25 to 55) with 25 male (62.5%) and 15 (37.5%) female with significant male preponderance. In this study road traffic accident was the commonest mode of injury (65%) and produced different types of fractures, followed by fall from height (22.5%), injury while playing sports (12.5%). Conclusions:The correct method of management of tibial condylar fractures depends on good clinical judgment. If rational treatment is to be instituted the surgeon must have sound knowledge of the personality of the injury and a clear understanding of the knee examination, imaging studies and must be familiar with variety of techniques available at present for treating tibial condyle fractures.

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“…Post-traumatic residual incongruities, such as articular surface defects and step-offs, have been studied with respect to their influence on contact surface area and corresponding increases in peak contact pressures (Brown et al, 1988;Brown et al, 1991). However, clinical experience shows that the presence versus absence of instability is a stronger predictor of osteoarthritis than incongruous but otherwise stable joints (Kannus and Jarvinen, 1988;Lovasz et al, 2001;Lansinger et al, 1986;Rasmussen, 1973). Furthermore, most incongruity studies have used static methods which are incapable of detecting instability-associated contact abnormalities.…”

Section: Introductionmentioning

confidence: 99%

A finite element exploration of cartilage stress near an articular incongruity during unstable motion

Goreham-Voss

McKinley

Brown

2007

Journal of Biomechanics

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Both instability and residual articular incongruity are implicated in the development of post-traumatic osteoarthritis following intra-articular fracture, but currently no information exists regarding cartilage stresses for unstable residual incongruities. In this study, a transversely isotropic poroelastic cartilage finite element model was implemented and validated within physiologically relevant loading ranges. This material model was then used to simulate the loading of cartilage during stable and unstable motion accompanying a step-off incongruity residual from intra-articular fracture, using load data from previous cadaver tests of ankle instability. Peak solid-phase stresses and fluid pressure were found to increase markedly in the presence of instability. Solid phase transients of normal stress increased from 2.00 to 13.8 MPa/s for stable compared to unstable motion, and tangential stress transients increased from 17.1 to 118.1 MPa/s. Corresponding fluid pressure transients increased from 15.1 to 117.9 MPa/s for unstable motion. In the most rapidly loaded sections of cartilage, the fluid was found to carry nearly all of the normal load, with the pressurization of the fluid resulting in high solid matrix tangential stresses.

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Tibial condylar fractures. A twenty-year follow-up.

Cited by 240 publications

References 0 publications

Radiographic and clinical results after surgically treated tibial plateau fractures at three and twenty two years postsurgery

Radiographic and clinical results after surgically treated tibial plateau fractures at three and twenty two years postsurgery

Various modalities of treatment of proximal tibial fractures: a prospective longitudinal study

A finite element exploration of cartilage stress near an articular incongruity during unstable motion

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