Soft Tissue Injuries Associated with Proximal Tibia Fractures

Abstract

The purpose of this study was to document the pattern of ligament and meniscal injuries that occur with proximal tibia fractures due to high energy trauma. Seventy patients with fractures of proximal tibia due to high-energy mechanisms were evaluated with magnetic resonance imaging (MRI) of the knee. All studies were reported by a single musculoskeletal radiologist who was blinded to surgical and physical findings. Of the 70 patients, there were 42 patients with AO/OTA type 41B2 (60%) fractures. On average, 70 % sustained a complete tear or avulsion of one or both cruciates.70% sustained collateral ligament injury.91% had lateral meniscal pathology.40% had medial meniscus tears. Of the 70 patients, 42 patients (60%) had Schatzker type II injuries, in which 90% had lateral meniscus tear, 80% MCL and ACL tear, 66% PCL and LCL tear. We adopted chi-square test to find the association. In our study, we found that there is a significant association between footprint avulsion of PCL and lateral meniscus (p value-0.038), between partial tear of LCL and lateral meniscus (p value-0.048), between partial tear of ACL and medial meniscus (p value-0.023). Also there is a significant association between complete tear of ACL and medial meniscus (p value- 0.019), between partial tear of PCL and medial meniscus (p value-0.007). But there is no significant association between ACL, PCL, MCL, LCL and Schatzker type (p value >0.05). We conclude MRI scanning should be considered for proximal tibia fractures due to high energy mechanism, which would help to identify and treat of associated soft tissue injuries. Keywords: Soft tissue injury, Proximal tibia fracture, Magnetic resonance imaging, ACL, PCL, LCL, MCL, Medial meniscus and lateral meniscus.