We carried out percutaneous, arthroscopically- and fluoroscopically-assisted osteosynthesis of fractures of the tibial plateau in 52 patients, of whom 38 were assessed using the HSS knee score and standing radiographs. We reviewed 31 AO type-B fractures and seven type-C fractures after a mean follow-up of five years (1 to 14). Fixation was achieved using percutaneous screws and/or an external frame; 33 associated intra-articular injuries, diagnosed in 21 out of the 38 patients, were treated arthroscopically.

Subjectively, 94.7% of the patients reviewed were satisfied. According to the HSS knee score 78.9% of the results were excellent, 13.2% good, 7.9% fair and none was poor. Narrowing of the joint space was found in 28.9% of the injured and 5.3% of the unaffected knees and axial deviation of 5° to 10° in 15.8% of the injured and 10.5% of the unaffected knees.

Of the 52 fractures, reduction was incomplete in one, and in two secondary displacement occurred, of which one required corrective osteotomy. Deep-venous thrombosis occurred in four cases.

The technique has proved to be safe but demanding. It facilitates diagnosis and appropriate treatment of associated intra-articular lesions.

The operative treatment of lesions of the anterior cruciate ligament (ACL) in athletes has been widely advocated and performed. We have investigated the outcome of non-operative management in a lower-demand, general population. We reviewed a consecutive group of 228 patients, which excluded professional and high-level athletes, for two to 12 years after an ACL lesion had been diagnosed by arthroscopy.

There was a low incidence of secondary ACL and meniscal surgery, 5.4% and 3.5% respectively, and all these procedures were performed during the first three years after the ACL injury.

We studied a subgroup of 109 patients with follow-up of at least five years (mean 8.5 years) and evaluated them using the IKDC score. The general outcome was reasonably satisfactory, with 23% in grade A, 50% in grade B, 21% in grade C and only 6.4% in grade D. We found no statistically significant prognostic effect within this group as regards age, activity levels, or the incidence of associated lesions.

In a prospective trial, biodegradable polyglycolic acid rods were compared with Kirschner wires for fixation of wrist fractures (Frykman types I, II, V and VI). Fifteen patients were randomly assigned to each treatment group. There was no significant difference between the groups with regard to age, sex ratio and fracture type. Kapandji's pinning technique was used in all cases. There were no significant differences in the results obtained in both groups at final follow-up. At three months and six months the functional results of the Kirschner-wire group were, however, significantly better (p < 0.05), due to numerous transient complications from foreign-body reactions to the polyglycolic acid rods. The use of polyglycolic acid rods is therefore not recommended for the fixation of distal radial fractures.

We have investigated a prospective series of 100 acute traumatic haemarthroses of the knee in a general non-athletic population. All the patients had normal radiographs and an aspiration which confirmed the haemarthrosis, before undergoing ligament testing and an arthroscopic examination under anaesthesia. Only one patient had no serious pathology; in the other 99 a total of 193 lesions were recorded. Thirty knees had only one isolated lesion, 69 had combined lesions. This study confirms the serious nature of an acute traumatic haemarthrosis of the knee, even in non-athletic patients.

This paper presents four patients with injuries to the thoracolumbar spine assessed by computerised tomography. This technique enabled an easy, quick and accurate diagnosis to be made, avoiding dangerous manipulation of the patient. The scans were analysed using the anatomical classification of Louis to evaluate the instability of the lesions. Control CT scans were used to monitor progress and to provide an accurate prognosis within acceptable limits of irradiation.