Effect of arthroscopic assisted minimally invasive treatment on tibial plateau fractures

Objective To observe the effect of minimally invasive reduction and internal fi xation assisted by arthroscopy on tibial plateau fractures. Methods Fifteen cases (17 platforms) of SchatzkerⅡ-Ⅵtibial plateau fractures with minimally invasive treatment assisted by arthroscopy in Beijing Hospital and Hami Red Star Hospital from 2008 to 2012 were enrolled in our study. Of the 15 cases, there were 10 males (12 platforms) and 5 females (5 platforms), with an average age of (45.00±5.23) years. Causes of injury included car accidents, bruises, ski sprains and normal falls. According to the Schatzker classification, there were 3 cases of typeⅡ, 5 cases of typeⅢ, 4 cases of typeⅣ, 3 cases of typeⅤ, and 2 cases of typeⅥ. The outcome of fracture reduction was observed under the microscope. K-wires were used to fix and reposition fractures temporarily, then anatomical plates were implanted to fi x the lateral or medial small incisions. Early postoperative rehabilitation exercises were done, and the fracture healing condition was followed up regularly. Results Surgeries were successfully performed on 17 platforms. The operating time was 60-90 minutes, and the time span of arthroscopy was about 10-15 minutes. The average follow-up time was (26.8±4.1) months, and the fracture healing time was 3-5 months. No complication such as lower limb thrombosis, tissue infection, and compartment syndrome was observed. According to the Lysholm knee score criteria, excellent therapeutic effect was achieved in 13 knees (76.5%), good in 3 knees (17.6%), and fare in 1 knee (5.9%), with the excellent rate of 94.1%. Conclusion Arthroscopy assisted minimally invasive treatment for tibial plateau fractures has optimal curative effect with few complications and less-injury, which is worthy of clinical application. It is applicable to the SchatzkerⅡ -Ⅵ type tibial plateau fractures, but it requires high surgical skills.