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

Jeung Tak Suh; Jae Min Ahn; Tae Wan Kim; He Myung Cho

doi:10.4055/jkoa.2012.47.2.96

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Suh, Ahn, Kim, and Cho: Arthroscopically Assisted Reduction and Internal Fixation of Intra-Articular Fractures of Tibial Plateau

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(2): 96-103.

Published online: 30 April 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.2.96

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

Jeung Tak Suh, M.D., Jae Min Ahn, M.D., Tae Wan Kim, M.D., He Myung Cho, M.D.

Department of Orthopaedic Surgery, Pusan National University School of Medicine, Busan, Korea.

Correspondence to: Jeung Tak Suh, M.D. Department of Orthopaedic Surgery, Pusan National University School of Medicine, 1-10, Ami-dong, Seo-gu, Busan 602-739, Korea. TEL: +82-51-240-7248, FAX: +82-51-247-8395, jtsuh@pusan.ac.kr

Received 7 May 2011 Revised 3 July 2011 Accepted 29 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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±8.5°. 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.

Keywords: tibia plateau fracture, reduction and internal fixation, arthroscopy

Figures and Tables

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.

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.

Table 1

Data of Surgical Patients: Schatzker Classification of Fracture Types and Associated Soft-Tissue Injuries

M, male; F, female; R, right; L, left; Lat., lateral; Med., medial; ACL, anterior cruciate ligament; PCL, posterior cruciate ligament; MCL, medial collateral ligament; LCL, lateral collateral ligament.

Table 2

Results of Rasmussen Clinical Assessment

Table 3

Results of Rasmussen Radiologic Assessment

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