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

Abstract

Background: Associated injuries in tibial shaft fractures are not investigated often, and their impact on patient outcome is not clear. In this study, associated knee injuries in tibial shaft fractures were arthroscopically investigated, and their impact on the outcomes of patients were evaluated. Methods: In a prospective study, 57 patients with closed tibial shaft fractures and without concomitant fibular fractures were included. Motor-vehicle accident was the most frequent mechanism of the injury. The fractures were treated with reamed and locked titanium intramedullary tibial nailing. The functional outcome was evaluated using the International Knee Documentation Committee score and compared between the patients with and without an ipsilateral associated injury. Results: The mean age of the patients was 33.2±13.2 years. The mean follow-up duration was 10.2±3.1 mo. In 35 patients (61.4%), at least one associated knee injury was detected. Chondral damage was the most frequent arthroscopic finding (n=23, 40.4%). The anterior cruciate ligament (ACL) injury was the second most frequent injury (n=7, 12.3%). No intervention was performed for chondral lesions and ACL tears. Meniscal injuries were detected in three (5.3%) patients only. The mean International Knee Documentation Committee score was 95.9±2.2 in patients with and 96.2±2.1 in patients without an arthroscopic finding (P=0.38). The severity of comminution was not correlated with the incidence of arthroscopic findings (r=0.089, P=0.45). Conclusions: Ipsilateral injuries are frequent in tibial shaft fractures. However, they do not seem to affect the functional outcome of patients, at least in short-term follow-up. Level of Evidence: Level III.