Artroscopically Assisted Surgical Treatment of Depressed Tibial Plateau Fractures and the Results

Abstract

In the tratment of depressed tibial plateau fractures, conservative treatment modalities or open surgical techniques have many complications and disadvantages. In order to minimize these, nowadays arthroscopically assisted surgical methods have been used. Between December 1993 and December 1995, 17 patients with depressed tibial plateau fractures were treated with arthroscopically assisted surgical technique. 14 patients with follow-up period longer than 6 months were included in this study. According to Hohl classification; in two cases type-I, one case type-II, eight cases type-III and three cases type-IV fractures were diagnosed. In all cases, following diagnostic arthroscopy, depressed plateau was elevated and reduced arthroscopically and fixed with one or two screws. In four cases, peripheral meniscal tears were diagnosed and sutured arthroscopically, in one case femoral avulsion of medial collateral ligament with bony fragment was fixed with a screw having washer. Average follow-up was 20 months (range 6 to 26 months). For radiological evaluation of patients; on direct AP and lateral X-rays, loss of reduction and signs of arthrosis were researched. For clinical evaluation. Hohl scoring was 94 points (over 100 points). There was no major complication. Arthroscopy as a minimal invasive method of the treatment of depressed tibial plateau fractures, enables better anatomic reduction, diagnosis and treatment of intra-articular pathologies and has lesser postoperative morbidity than conservative and open surgical techniques.