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Case 1: (A) The patient presented highly contaminated Gustilo-Anderson type 3B open fracture upon initial trauma. (B) Uncontained medial proximal tibial bone defect secondary to AO 41-B1 fracture and proximal fibular fracture were observed in the immediate posttraumatic radiography.
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On admission, he was suspected to have sustained Gustilo-Anderson type 3B open fracture with AO 41-B1 fracture based on the photographic and radiographic documentation of the initial injury (Fig. 1A and B).
Case 1: Three-dimensional computed tomography showing 15% defect in the medial tibial plateau articular surface.
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The defective area was approximately 15% of the medial tibial plateau articular surface in three-dimensional computed tomography (3D CT) measurement using picture archiving and communication system (PACS) region-of-interest (ROI)-curved function in Maroview ver. 5.3 PACS (MAROTECH, Republic of Korea) (Fig. 2).
Case 1: 22 months after the trauma, the patient's left lower extremity mechanical alignment showed 2  varus deformity in the long-standing anteroposterior radiograph.
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His knee joint range of motion was limited to only 85  flexion from a 5  flexion contracture (Fig. 3).
Case 1: MR image showing the medial meniscus covered with soft tissue fixed on the edge of the bone defect by a suture anchor.
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The medial meniscus, which was unsupported by a bony structure but surrounded by soft tissues fixed on the edge of the bone defect by a suture anchor, was detected on magnetic resonance imaging (MRI) (Fig. 4).
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Case 2: (A) Radiographs taken immediately after the initial injury in the local clinic. The patient presented severe crushing and bone loss in the medial aspect of the left knee joint. (B,C) At 16 months after the initial trauma, the patient visited our clinic with 9  varus deformity on the left knee.
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At the time of his initial injury, he sustained multiple skeletal traumas, including right femoral subtrochanteric fracture (AO 31-A3), left femoral shaft fracture (AO 32-A2), bilateral malleolar fracture (AO 43-B1 and 44-A1), and severe crushing in the medial aspect of his left knee which involved both the medial femoral condyle (AO 33-B2) and the medial tibial plateau (AO 41-B1) (Fig. 5).
Case 2: (A-D) Three-dimensional computed tomography showing 40% defect in the medial tibial plateau articular surface, whereas the medial femoral condyle was relatively spared.
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Preoperative measurement using PACS ROI-curved function in 3D CT revealed that almost 40% of the medial tibial plateau articular surface was lost, whereas the medial femoral condyle appeared to have relatively preserved articulating bone stock even if the bone did not seem to have an intact articular cartilage (Fig. 6).