A retrospective review of 53 patients with articular fractures of the distal tibia was carried out at the Orthopedic Department in Hallym Medical University. During a five-year period from 1987 to 1992, these 53 patients had operative or
nonoperative
treatment of fractures with at least a 12-month follow up period.
We classified the fractures into four types according to the severity of the injury, and measured the axis of the distal tibial metaphysis, the length of distal fibula, and the congruity of the articular surface of the distal end of the tibia.
There were no significant differences of the final clinical result between closed and open methods of treatment in the type-1, but a good or excellent result was obtained by open reduction and internal fixation in 80% of the type-2 fractures. Of
our
severe fractures in our series (type-3 and type-4), and excellent or good result occured less than 50% without regard to the method of treatment.
We believe that the most important factors related to the final clinical result were the type of fracture and the accuracy of the reduction rather than the method of the treatment, so we emphasize the necessity of the understading of the pattern
of
the
fracture and its anatomical reduction.
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