Arthroscopically assisted osteosynthesis of the tibial plateau: Principles and case report

Arthroscopically assisted osteosynthesis of tibial plateau fractures enables an exact assessment of the joint impression as well as the intra-articular form of fragmentation. Additionally, therapeutic repositioning of fragments and elevation of the impression area to the joint level can be controlled by arthroscopy. In order to identify the area of elevation the anterior cruciate ligament (ACL) guide can be used to place the guidewire exactly in the fracture area and a dilator is advanced over the wire to elevate the impressed fragments. The articular surface can be assessed better by arthroscopy than by fluoroscopy, which is also true for the repositioned clefts. Concomitant injuries, such as ACL ruptures or meniscal tears can be diagnosed. Meniscal tears can be immediately sutured under arthroscopy. © 2017, Springer Medizin Verlag Berlin.