The purpose of this study was to determine the value of arthroscopy in the management of tibial plateau fracture. In a retrospective study of 39 patients, arthroscopically assisted manageement of tibial plateau fracture with fixation of
cancellous
screws or T-plate using C-arm was performed, and analysed from June 1987 to April 1994 with follow up for over 1 year.
1. According to Hohl classification, there were eleven type I, six type II, twelve type III, seven type IV, and three type V.
2. Associated jntraarticular injuries occured in eight lateral and six medial meniscal tears, all of which were managed by arthroscopic partial meniscectomy or meniscoresis.
3. Six cases of medial collateral ligament and two cases of lateral collateral ligament injuries were treated by standard techniques.
4. Bone graft with elevation using bony chiesel under the arthrocopy was perfrmed 13 in 39 cases(30%).
5. Two patients had significant limitation of motion after 6 months, and one patient had postoperaitve instability.
6. Overall results which were evaluated according to Porter´s evaluation systems were ˝Acceptable˝in 36 cases(90%), ˝Unacceptabel˝in 3 cses910%).
So arthroscopy bridges the advantage of accurate reduction and rigid fixation without extensive operative exposure. In addition, arthr5oscopy allows thorough lavage, removal of loos fragment and accurate diagnosis of associated intraarticular
pathology.
Since extensive exposure is avoided, rapid recovery with reduced pain and early full ROM are achieved in patients managed arthroscopically.
|