Arthroscopically assisted treatment for Schatzker type I-V tibial plateau fractures

Objective: To report the clinical outcome of arthroscopically assisted treatment for tibial plateau fractures. Methods: A total of 39 patients with tibial plateau fractures were treated by arthroscopic fixation from February 2002 to December 2005, including 11 patients with bony avulsion of the anterior cruciate ligament and 19 with meniscal injury. There were 4 cases of type I fracture, 12 type II, 9 type III, 12 type IV and 2 type V according to Schatzker criteria. Firstly, the combined injuries were treated. Then the plateau fractures with the displacement over 3 mm or more were reduced and fixed. Finally, the internal fixation was observed by X-ray equipment. Postoperative management was early motion and delayed weight bearing. Results: All the fractures healed in 3 or 4 months. All patients were followed up for 1 to 5 years after operation. No case had severe complications, such as poor wound healing, infection, osteofascial compartment syndrome and osteoarthritis. According to the Rasmussen scoring system, 36 cases obtained excellent or good results and the other 3 cases had moderate clinical results. The average score was 26 +/- 3. Conclusions: As an adjuvant treatment of intraarticular fractures such as tibial plateau fracture, arthroscopy has many advantages. It can treat associated intraarticular soft tissue components, visualize the chondral surface reduction, lavage the hematoma and smaller loose fragments, decrease soft tissue dissection, reduce the risk of scarring and promote rapid recovery.