All-Arthroscopic Treatment of Schatzker Type III Lateral Tibial Plateau Fracture Without Fluoroscopy

Abstract

Tibial plateau fracture treatment remains challenging for orthopaedic surgeons around the world, especially in case of type III fractures according to the Schatzker classification, which are a pure depression of the lateral tibial plateau. Whereas open surgical procedures are associated with increased soft-tissue trauma because of the extent of the surgical approach and do not always allow for proper visualization of the fracture site, arthroscopic-assisted surgeries have been proven to have benefits over the former in terms of minimizing soft-tissue trauma, improved visual control of the fracture reduction, and the time of recovery. Most arthroscopic techniques, however, require using fluoroscopy. We present an all-arthroscopic procedure for Schatzker type III lateral tibial plateau fractures with using a trans-septal portal for visualization, which does not demand fluoroscopy.

Arthroscopic-Assisted Reduction of Depressed Lateral Tibial Plateau Fracture Using Precision Drill Guide and Fresh-Frozen Femoral Head Allograft

“…Hermanowicz et al. 7 , 8 described an all-arthroscopic treatment of posterolateral and lateral tibial plateau depressed fracture without fluoroscopy using a trans-septal portal and biocomposite screws. Ackermann et al.…”

“…Several surgical techniques have been reported to fix the depressed lateral tibial plateau fractures, including open, fluoroscopic-assisted, and arthroscopic-assisted techniques. 1 , 5 , 6 , 7 , 8 , 9 We propose an arthroscopic-assisted reduction of depressed lateral tibial plateau fractures using an ACL tibial drill guide and a fresh-frozen femoral head allograft.…”

Technique for Treatment of Subchondral Compression Fracture of the Lateral Femoral Condyle Associated With ACL Tear

“…This is the main benefit of the technique, because without such restoration knee subluxations could occur, especially if a "knee Hill-Sachs lesion" engaged with a "knee Bankart lesion." 10 It would greatly elevate the risk of ACL reconstruction failure, meniscal tears, and OA development and impair the patient's quality of life. 2 The next benefit of the presented technique is its minimal invasiveness, allowing for a faster recovery.…”

Arthroscopically assisted osteosynthesis of tibial plateau fracture, Schatzker type III: Case report

“…The main goal in the treatment of these injuries is establishing the best possible, hopefully anatomical, repositioning of the tibial joint surface and achieving ligamentous stability of the joint, while also achieving knee axis alignment and a full scope of movement in the joint [4]. As these are intra-articular fractures, such goals are attainable almost exclusively with the surgical method.…”

“…At present, there is a certain dissensus as to which surgical technique should be applied in the treatment of these fractures. The procedures most commonly applied are open reduction and internal fixation -ORIF, and arthroscopically assisted reduction and internal fixation -ARIF [1,[4][5][6][7].…”