Percutaneous Repair of a Schatzker III Tibial Plateau Fracture Assisted by Arthroscopy.

PURPOSE: Tibial plateau fractures are articular fractures that sometimes prove difficult to effectively manage and treat. Although fluoroscopy is frequently used to assess the articular reduction in the surgical repair of tibial plateau fractures, this video demonstrates the additional benefit of arthroscopy in assisting with the articular reconstruction of a Schatzker III tibial plateau fracture.

METHODS

The goal of operative treatment of tibial plateau is reconstruction of the articular surface followed by reestablishment of tibial alignment. Arthroscopy has been advocated as a possible supplement to the operative treatment of tibial plateau fractures. Arthroscopy-assisted fracture reduction has been shown to provide a significantly improved visualization of fracture fragment displacement when compared with traditional fluoroscopy use in select cases.

RESULTS

This video demonstrates the use of arthroscopy to visualize the articular surface and aid in reduction during fixation of a tibial plateau fracture. Initially, arthroscopic visualization confirms depression of lateral tibial plateau and the elevation of the fractured segment. After fixation with 2 partially threaded cancellous screws, arthroscopy confirms articular reduction and normal relation of lateral meniscus to the articular surface.

CONCLUSIONS

Arthroscopic visualization is a reliable technique for assessing articular reduction during surgical repair of a tibial plateau fracture. In addition, this technique enables the surgeon to assess for soft tissue injuries that could potentially go undiagnosed.