Arthroscopically assisted reduction and internal fixation of tibial plateau fractures: report of twenty cases.

The purpose of this study was to evaluate the results of arthroscopically assisted reduction and internal fixation of tibial plateau fractures. We report on 20 patients with 20 fractures with a mean follow-up time of 39 months (27-64 months). All fractures were evaluated according to the Schatzker classification. Under arthroscopic guidance, the fractures were reduced and associated intra-articular lesions were addressed appropriately. For split fractures a limited lateral approach, or the joystick technique, was used. Depression fractures were reduced with the aid of an anterior cruciate ligament (ACL) tibial guide. Postoperatively, immediate mobilisation and continuous passive motion was encouraged. A hinged brace provided stability and the patients were not allowed to bear weight for at least six weeks. According to the Rasmussen grading system, 18 out of 20 patients scored an excellent (15 patients), or a good (3 patients) result. One patient had a fair result. The only poor result we noted was caused by the fact that we were unable to reduce the fracture arthroscopically and had to perform an arthrotomy. We experienced no complications due to the arthroscopic procedure.