J Korean Orthop Assoc.  2012 Apr;47(2):96-103. 10.4055/jkoa.2012.47.2.96.

Arthroscopically Assisted Reduction and Internal Fixation of Intra-Articular Fractures of Tibial Plateau

• Suh JT
• Ahn JM
• Kim TW
• Cho HM

• KMID: 2185384
• DOI: http://doi.org/10.4055/jkoa.2012.47.2.96

Abstract

PURPOSE
To evaluate clinical and radiological results of arthroscopically assisted reduction and internal fixation of intra-articular fractures of the tibial plateau.
MATERIALS AND METHODS
Between July 2003 and June 2009, we performed arthroscopy and fluoroscopy-assisted reduction and internal fixation for tibia plateau fracture. Our study included 21 patients who had been followed-up for more than 18 months. We used the Knee Society Knee Score (KSS) and Knee Society Functional Score (KSFS) for the clinical evaluation. We used the Rasmussen Radiological Score for the radiological evaluation.
RESULTS
At the last follow-up, all 21 cases showed bone union, and the mean range of movement was 115.5+/-8.5degrees. According to the KSS and KSFS, we obtained excellent or good results in 18 cases (85%). We obtained excellent or good results in 19 cases (90%) each by the Rasmussen Clinical Score and Rasmussen Radiological Score, respectively.
CONCLUSION
The 2 year follow-up of arthroscopy assisted surgery showed relatively satisfactory results.

Keyword

tibia plateau fracture; reduction and internal fixation; arthroscopy

MeSH Terms

Arthroscopy
Follow-Up Studies
Humans
Intra-Articular Fractures
Knee
Tibia

Figure

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  Figure 1 A 17-year-old female with lateral plateau fracture. (A, B) Antero-posterior & lateral radiographs show lateral tibial plateau fracture. (C) Preoperative computed tomography (CT) shows Schatzker type II plateau fracture. (D) Arthroscopy shows depressed fracture fragment. (E) Arthroscopy-assisted reduction was done. (F) Meniscal injury was found and repaired with absorbable sutures. (G, H) Internal fixation with cannulated screws was done. (I) Postoperative CT shows anatomically reduced articular surface.

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  Figure 2 A 53-year-old female with tibial plateau fracture. (A, B) Antero-posterior & lateral radiographs show lateral tibial plateau fracture with anterior cruciate ligament (ACL) avulsion fracture. (E) Arthroscopy shows ACL avulsion fracture and (F) ACL pull-out suture was done. (C, D) Arthroscopy-assisted reduction & fixation with locking compression plate was done. (G) Second-look arthroscopy shows intact ACL & ACL origin.

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