ArticleJournal of clinical orthopaedics and trauma2022
Open wedge osteotomy of medial tibial condyle gives good results in management of neglected diagonal lesions of proximal tibia.
Article in Journal of clinical orthopaedics and trauma, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Depressed fractures of anteromedial tibial plateau are often underappreciated and treated inadequately. When these fractures are accompanied by injuries of posterior cruciate ligament and postero-lateral corner, they are called as diagonal lesions. There are very few publications on the management of such injuries in chronic stage. The purpose of our study is to describe our results in management of these neglected fractures using open wedge osteotomy of medial tibial condyle (OWOMTC). Methods: This is a retrospective study of ten patients. KOOS score and Tegner and Lysholm score were recorded preoperatively and at three, six, twelve and twenty four months after surgery to assess the functional outcome. Medial proximal tibial angle (MPTA) and tibial slope were recorded before and after surgery. Results: All cases had posterior cruciate ligament (PCL) and posterolateral corner (PLC) injuries. There was no anterior cruciate ligament (ACL) injury. MPTA was corrected from mean 76.2° ± 3.7° to mean 86.4° ± 3.2°. Mean tibial slope was increased from -4° ± 3° to mean tibial slope of 7.6° ± 2.2°.Tegner and Lyshom score improved from mean of 38-88 (p < .05) at final follow-up. KOOS score improved from mean of 32-86 (p < .05) at final follow-up. Union was achieved in all the cases. None of the cases required ligament reconstruction. Conclusions: We conclude that OWOMTC is a useful method to manage neglected depressed fractures of anteromedial tibial plateau accompanied by PCL and PLC injury (diagonal injury). This procedure can restore limb alignment, congruency and stability of knee joint without any soft tissue reconstruction and change in the patellofemoral kinematics.
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