[Injury sequelae and late damage of dislocation fracture of the head of the tibia]. / Verletzungsfolgen und Spätschäden der Luxationsfraktur des Tibiakopfes.

ABSTRACT

Consequences of injury as well as succeeding joint-impairment after fracture dislocation of the tibial head are analysed. Of 38 patients who had undergone operative therapy for fracture dislocation of the tibial head between 1982 and 1991, 30 were followed up after a mean of 6.3 years. With an average age of 46.8 years and a distribution between sexes of 26 men vs. 12 women, types II (17) and V (14) (classification acc. to Moore) clearly outweighed types III (3) and IV (3) as well as type I (1). Causes of injury were dominated by traffic accidents (22/38), 9 patients suffered from accompanying ipsi-, another 9 from contralateral injuries of their lower extremities. For evaluating follow-up results, both Lysholmscore and IKDC-knee-evaluation-form were employed. The latter qualifies the overall result as "normal", "nearly normal", "abnormal" or "severely abnormal". None of the knee-joints assessed was evaluated normal. There were only 2 patients to be qualified nearly normal, whereas 5 had to be assessed abnormal and 23 severely abnormal. These poor results were mainly due to persistent symptoms (pain, swelling, giving-way) (30/30), limited range of motion (27/30) as well as impairment of joint-stability (25/30). Our results stress the need for sophisticated operative and p.op. therapy of these complex injuries.