Ligamentous injuries of the ipsilateral knee have been documented in
association with 25 to 35 percent of fractures of the femoral shaft.
However, to our knowledge, a similar association between ligamentous
injuries of the knee and fracture of the tibial shaft has not been studied
prospectively. To determine if there was such an association, a prospective
study was conducted in which the knees of fifty patients who had a fracture
of the ipsilateral tibial shaft of varying severity were examined manually
while the patient was under general anesthesia. Eleven patients (22
percent) were found to have sustained an injury to at least one ligament of
the knee that resulted in increased laxity of 2+ or more. One knee had
dislocated. On the basis of the results of this study, we believe that,
after stabilization of a fracture of the tibial shaft, it is essential to
examine the knee thoroughly to identify any associated ligamentous
injuries.