By Robert E. Hunter
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Additional resources for AANA Advanced Arthroscopy. The Knee
Other postoperative measures that can be taken to prevent stiffness include immediate quadriceps exercises, patellar mobility exercises, and obtaining early extension. Once arthrofibrosis has occurred, conservative treatment is based on the degree of involvement.
15-17 More studies are needed to answer the question of anatomic versus overreduction, but there is consensus that any displacement requires at least an anatomic reduction. Management has been based on the Meyers and McKeever classification, with recommendations for immobilization in extension for type I fractures. Some controversy exists in regard to what degree the knee is to be extended for nonoperative management. 19 These authors favor immobilization in full extension to avoid a flexion contracture, which can occur if the knee is kept in a flexed position.
2,4-7 Closed reduction may be attempted for large type IIIB fractures because associated condylar contact may allow bony reduction after aspiration and hyperextension. 2 An impressively large series by Chan and coworkers3 is summarized in Table 3-1. The key point is that fracture types I, II, III, and IV had 100% satisfactory results. 5% satisfactory results and Schatzker type VI had 90% satisfactory results. Hunter and Willis8 have described the outcome of suture or screw fixation of Myers and McKeever types II and III tibial intercondylar eminence fractures.
AANA Advanced Arthroscopy. The Knee by Robert E. Hunter