[Total knee replacement for primary treatment of intra-articular tibial head fractures in elderly patients].

Intra-articular fractures of the tibial head pose a huge challenge for the surgeon. An increase of these fractures, especially in the elderly, has been observed in recent years. The cause of injury in the elderly is in most cases a slight trauma. The mechanism of dislocation plays only a subordinated role. These are serious injuries of the bone, which are accompanied by soft tissue lesions. Furthermore, there are some factors, which could have a negative effect on the treatment, such as osteoporosis, diseases of the vascular system, osteoarthrosis, limited coordination, and insufficient autologous cancellous bone. Every surgeon is aware of secondary, clinically relevant deficits after operative treatment of the tibial head in the elderly. We treated two elderly patients with different additional findings by total knee replacement.