Arthroscopically assisted treatment of tibial plateau fractures in 38 cases / 中国微创外科杂志

ABSTRACT

Objective To explore clinical results of arthroscopically assisted treatment for tibial plateau fractures.Methods Thirty-eight cases of tibial plateau fractures were treated under arthoscope.According to the Schatzker classification,there were 8 cases of type Ⅰ, 10 cases of type Ⅱ,11 cases of type Ⅲ,4 cases of type Ⅳ,3 cases of type Ⅴ,and 2 cases of type Ⅵ,respectively.Routine arthoscopic examination of the knee found 15 cases of meniscus injury,12 cases of partial or complete rupture of anterior cruciate ligament(ACL),and 7 cases of medial collateral ligament (MCL) injury.Fracture reduction and fixation was performed under arthroscopic surveillance.The tibia plateau fracture was fixed with the cancellous bone screws(Schatzker Ⅰ~Ⅲ) or minimally invasive plate osteosynthesis(Schatzker Ⅳ~Ⅵ).Results The operation time was 30~72 min(mean,40 min) and the intraoperative blood loss was less than 20 ml.A follow-up was carried out in 36 cases for 4~36 months(mean,15 months).The X-ray findings at the 3 postoperative month showed bone union in all the 36 cases.There were no wound or joint infection,skin necrosis,or delayed union.The Hospital for Special Surgery(HSS) knee scores 3 months after operation revealed excellent results in 28 cases,good in 6 cases,and fair in 2.The main untoward manifestations at this period were lacking of muscle force and limited extension and incurvation of the knee joint.The HSS scores 6 months after operation showed excellent result in 33 cases and good in 3 cases. Conclusions Arthroscopically assisted treatment of tibial plateau fractures has advantages of accurate reduction and fixation and early detection and management of associated intraarticular injuries.Different methods of internal fixation should be chosen according to different types of facture.