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Background <p>Multiligamentous knee injuries (MLKIs) are challenging to treat,. &#xa0;the presence of a malunited proximal tibia fracture complicates the management &#xa0;We aim to highlight a combined approach, illustrating the importance of addressing malunion and ligament injuries in a staged manner.</p> Case Report <p>A&#xa0;20-year-old male presented with a 2-month-old malunited fracture of the left proximal tibial medial condyle with&#xa0;knee instability. Radiographs identified a Schatzker type 4 proximal tibial fracture, a malunited depressed medial plateau fracture, a malunited PCL avulsion fracture, a Segond fracture, and a fibular head avulsion fracture. A valgus corrective osteotomy was performed, Ligament surgeries for ACL, PCL, and PLC were conducted in stages. At&#xa0;follow-up 12&#xa0;months after the final surgery revealed minimal knee effusion, no varus or valgus laxity, active range of motion upto 150 degrees, no extensor lag.</p> Conclusion <p>The effective treatment was&#xa0;achieved by addressing bone abnormalities first, followed by a delayed ligament reconstruction.</p>

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Malunited Proximal Tibia Fracture with Multi-ligament Knee Injury Managed by Tibial Condylar Valgus Osteotomy and Staged Ligament Reconstruction: A Case Report

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Amit Kumar,
  • Himanshu J Ashtankar,
  • Mohit Verma,
  • Lyakat Khan,
  • Aishwarya Raj Baghel

摘要

Background

Multiligamentous knee injuries (MLKIs) are challenging to treat,.  the presence of a malunited proximal tibia fracture complicates the management  We aim to highlight a combined approach, illustrating the importance of addressing malunion and ligament injuries in a staged manner.

Case Report

A 20-year-old male presented with a 2-month-old malunited fracture of the left proximal tibial medial condyle with knee instability. Radiographs identified a Schatzker type 4 proximal tibial fracture, a malunited depressed medial plateau fracture, a malunited PCL avulsion fracture, a Segond fracture, and a fibular head avulsion fracture. A valgus corrective osteotomy was performed, Ligament surgeries for ACL, PCL, and PLC were conducted in stages. At follow-up 12 months after the final surgery revealed minimal knee effusion, no varus or valgus laxity, active range of motion upto 150 degrees, no extensor lag.

Conclusion

The effective treatment was achieved by addressing bone abnormalities first, followed by a delayed ligament reconstruction.