Arthroscopic and Conventional Treatment of Lateral Tibial Plateau Fractures

Kim, Jung Man; Han, Chang Whan; Son, Han Seok

Abstract

The goals in the treatment of a tibial plateau fracture are to obtain a stable, aligned, mobile and painless joint and to minimize the risk of post-traumatic osteoarthritis. Most recently the management of tibial plateau fractures has been via arthroscopy. Proponents of arthroscopic techniques advocate their use not only to better visualize the surface of the tibia but also to evaluate the rest of the joint. This retrospective study compared the results of arthroscopic and conventional treatment of tibial plateau fractures from January 1988 through April 1995. Forty-seven knees of tibial plateau fractures were involved in this study. Sixteen of these patients were treated with arthroscopic reduction and autogenous bone graft with or without internal fixation, while the remaining 31 underwent open reduction, bone graft and internal fixation. The results are as follows: 1. The average time to full weight bearing was 10.2 weeks (range 7-14 weeks) in the arthroscopic group and 13.5 weeks(7.2-18 weeks) in the open reduction group. 2. The incidence of lateral meniscus tear was 56%(9/16) in the arthroscopic reduction group and 29%(9/31) in the open reduction group. 3. Flexion of at least 130 was obtained in 81%(13/16) of arthroscopic reduction group, while only Tabl 58%(16/31) in the open reduction group. Full extension was obtained in 93%(15/16) of arthroscopic reduction group, and in 83%(26/31) in the open reduction group. 4. Complications occurred more frequently in the open reduction group than in the arthroscopic reduction group.