Year: 2025 | Month: April | Volume: 12 | Issue: 4 | Pages: 423-429
DOI: https://doi.org/10.52403/ijrr.20250449
Correction of Deformity and Improvement of Functional Outcomes in Neglected Tibial Fracture with Post-Traumatic Osteoarthritis Through Long Stem Total Knee Arthroplasty: A Case Report
Adiet Wahyu Kristian1, Cokorda Gde Oka Dharmayuda2, Agus Eka Wiradiputra2, Benedictus Anindita Satmoko1
1Resident, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
2Orthopaedic Surgeon, Bali Royal Hospital, Denpasar, Bali, Indonesia
Corresponding Author: Adiet Wahyu Kristian
ABSTRACT
Background: Tibial plateau fractures, which account for 1% of all fractures, can lead to significant complications such as post-traumatic osteoarthritis (PTOA). This case report describes the management of a neglected tibial plateau fracture leading to PTOA treated with total knee arthroplasty (TKA).
Case report: A 55-year-old male presented with severe pain and impaired mobility in the right knee, seven months post a fall that resulted in a tibial plateau fracture. The patient had not sought medical treatment initially due to fear of surgery. Physical examination and imaging confirmed a malunion fracture with associated PTOA. The patient underwent right total knee replacement (TKR) with a long stem prosthesis. Postoperative care included antibiotic prophylaxis, anticoagulation, and early rehabilitation.
Discussion: Neglected tibial plateau fractures can lead to malunion and PTOA due to altered biomechanics and joint incongruency. Surgical intervention aims to restore joint stability and alignment, crucial for functional recovery. This patient's postoperative outcomes demonstrated significant improvement in pain, mobility, and knee function, highlighting the efficacy of TKA in managing advanced PTOA secondary to neglected fractures.
Conclusion: This case illustrates that TKA can effectively correct deformity and enhance functional outcomes in patients with neglected tibial plateau fractures complicated by PTOA. Early diagnosis and appropriate surgical intervention are critical in preventing long-term joint dysfunction.
Keywords: neglected fracture dislocation, hinged external fixator, interposition arthroplasty, early mobilization, case report
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