Corrective Osteotomy and Ligament Reconstruction in Malunited Tibial Plateau Fractures – A Report of Two Cases

Abstract Tibial plateau fractures (TPFs) with concomitant soft-tissue meniscus and ligament injuries are common, ranging from 50% to 90% of cases depending on the use of diagnostic modality. However, no direct correlation can be drawn. Usually, fracture is taken care on priority, and soft-tissue injuries either not diagnosed or untreated result in severe disability due to instability and articular cartilage degeneration. Unstable knee fracture fixation is likely to be failed and develop malunion, ensuing early arthritis and subsequent joint replacement. Hence, effective management of fracture and ligament injury is essential for good outcome. Previous studies have described corrective osteotomy in malunited TPF, but malunited TPF associated with ligament injuries is rare and challenging. These malunions also alter the slope of the tibia that worsens the instability. In the current series, we analyze the injury patterns in patients with neglected malunited tibial fracture and management by corrective osteotomy and ligament reconstruction with successful outcome and joint salvage.