[Fractures of the proximal tibia and knee ligament injuries]

The risk of secondary osteoarthritis after proximal tibial fractures is influenced by the reconstruction of both the articular surface and associated knee ligament injuries. In a follow-up of 69 operatively treated tibial head fractures 36.2% revealed ligamentous damages. At high risk were young male patients with fractures of the medial or both tibial condyles. Only 33% of the ligament damages were the cause of fracture dislocations as described by Moore. Avulsion fractures of the knee ligaments can be successfully treated on by primary fixation. For ruptures of the medial collateral ligament a functional therapy is often sufficient whereas damages of the cruciate ligaments need secondary reconstruction.