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Abstract Presented at the 26th Annual Meeting of the Arthroscopy Association of North America| Volume 23, ISSUE 6, SUPPLEMENT , e22, June 2007

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Arthroscopic Reduction and Internal Fixation of Tibial Plateau Fractures (MIS Technique) (SS-43)

      Summary

      Tibial plateau fractures, result of a high-energy trauma and commonly associated with significant soft-tissue and intra-articular injuries. Minimally invasive surgery offers less soft tissue damages, good reduction and stable fixation of the fracture. This study evaluates the combined arthroscopic and radioscopic assisted reduction and internal fixation of tibial plateau fractures 14 out of 16 patients had satisfactory result. Arthroscopic reduction and internal fixation can restore articular congruity with rigid fracture stabilization. 10 patients had associated intraarticular injury treated at the time of arthroscopy. Arthroscopy can provide definitive treatment, less stripping, better visualization, and early return to physical activities with less damage to intraarticular structures.
      Tibial plateau fractures are complex lesions capable of causing severe consequences if not appropriately treated. They are often the result of a high-energy trauma and commonly associated with significant soft-tissue and intra-articular injuries. Different therapeutic options can be managed in the treatment of these lesions. Minimally invasive surgery offers several advantages compared to other surgical techniques and allows, with less additional soft tissue damages, good reduction and stable fixation of the fracture.
      In this study we assessed the results of the combined arthroscopic and radioscopic assisted reduction and internal fixation of tibial plateau fractures in 16 patients affected by Schatzker type I, II, III, IV fractures. According to Hohl’s and Rasmussen’s grading system, 14 out of 16 patients scored a satisfactory result. We experienced no complications due to arthroscopy.
      Arthroscopic reduction and internal fixation of tibial plateau fractures can facilitate restoration of articular congruity while permitting rigid fracture stabilization. Sixty-four percent of patients had associated intraarticular injury diagnosed and treated at the time of arthroscopy. Arthroscopic reduction and internal fixation provides an accurate assessment of, and allows definitive treatment for, intraarticular injuries associated with tibial plateau fractures. The technique allows less soft tissue stripping than with traditional arthrotomy, better visualization of the articular surface, early return to physical activities, and obviates the need for meniscal detachment and repair.