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The Journal of Bone and Joint Surgery, Vol 68, Issue 1 13-19, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
Tibial condylar fractures. A twenty-year follow-up
O Lansinger, B Bergman, L Korner and GB Andersson
In a series of 260 fractures of one or both tibial condyles that were
treated at the Department of Orthopaedic Surgery I, Sahlgren Hospital,
Goteborg, Sweden, between 1959 and 1965, the main indication for surgical
treatment was clinical evidence of instability of the extended knee joint.
Two hundred and four of the patients were followed for 7.3 years and the
results were presented in 1973. A longer follow-up of twenty years on 102
of these 204 patients is reported in this paper. The distributions of
fracture types and treatments were similar in the two series and, in
general, the results were unchanged. Ninety per cent of the patients
achieved an excellent or good result and 10 per cent achieved a fair or
poor result. The inferior results were seen in the unstable split-depressed
and depressed fractures in which a depression of the articular surface of
more than ten millimeters persisted. The results of this study support the
conclusions that were made in 1973: that patients without clinical
impairment of lateral or medial stability of the extended knee joint should
be treated non-operatively, irrespective of the roentgenographic appearance
of the fracture, and that those with an unstable knee joint should be
treated operatively. We have achieved satisfactory results after
percutaneous cerclage wiring in split fractures and after open reduction
and bone-grafting in split-depressed and depressed fractures.
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