Published online Apr 18, 2015. doi: 10.5312/wjo.v6.i3.363
Peer-review started: November 17, 2014
First decision: December 26, 2014
Revised: January 31, 2015
Accepted: February 10, 2015
Article in press: February 12, 2015
Published online: April 18, 2015
The management of a combination of fracture and multiligament knee injury (MKI) in traumatic knee injury remains controversial, and there are evolving treatment recommendations. Currently, there are no studies focusing on older adult patients with MKI’s in combination with tibia fractures. As a result, there is no well-established treatment algorithm for older adult patients with these complex injuries. We report two cases of MKI’s with concomitant fractures in patients fifty years of age or older. Both patients were treated surgically for their associated tibial plateau fractures, but were managed with conservative treatment of the multiligamentous knee injuries. We also provide a review of the literature and guidelines for older adult patients with these types of complex traumatic injuries. Early to mid term acceptable outcomes were achieved for both patients through surgical fixation of the tibial plateau fracture and conservative treatment of the ligament injuries. We propose a comprehensive treatment algorithm for management of these complex injuries.
Core tip: Extensive review of the literature illustrates the limited evidence on these types of complex knee injuries. Patients with multiligament knee injury (MKI) and tibial plateau fractures require a complex treatment algorithm optimized to patient specific injuries and expectations. We propose an algorithm for treating MKI with concomitant fracture in middle aged-patients.