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  • Title: [Reconstructive surgery following malunion of intra-articular fractures of the knee joint].
    Author: Olerud S, Tjernström B.
    Journal: Orthopade; 1990 Nov; 19(6):378-87. PubMed ID: 2277710.
    Abstract:
    The anatomical reduction of intra-articular knee fractures is a major challenge if a satisfying functional result and limited post-traumatic arthrosis is to be obtained. In some cases even after malunion a good result can be achieved. In this paper, our experience with reconstructive surgery is described after a description of possible extended approaches to the knee and osteotomy techniques and advanced osteosynthesis. Four illustrated cases of distal femoral and three of proximal tibial reconstruction are discussed. In all patients the primary treatment led to malunion of the comminuted fractures. The only complication seen was the breaking of an angulated plate at the distal femur and even here, after re-osteosynthesis, normal healing occurred. In all cases a satisfactory knee motion was achieved: 90 degrees of flexion in the femoral group and 120 degrees in the tibial group was reached without any extension deficit. Alignment and axial correction were optimal in all patients. From these results we believe that reconstructive surgery can ba advocated for malunited knee fractures and that it represents a primary alternative to joint replacement surgery and arthrodesis.
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