Arthroscopy-Assisted Surgery for Tibial Plateau Fractures

Chen, Xing-Zuo; Liu, Chenggang; Chen, Ying; Wang, Liqiang; Zhu, Qianzheng; Lin, Peng

doi:10.1016/j.arthro.2014.06.005

Cited by 71 publications

(70 citation statements)

References 34 publications

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“…With the development of image intensifiers and arthroscopy, percutaneous reduction and internal fixation has become more popular in the treatment of tibial plateau fractures, especially for the cases with only monocondylar involved 10,21 . This systematic review of the literature showed that, in general, the clinical and radiological results of more than 85% of patients were good to excellent according to the Rasmussen scoring system.…”

Section: Discussionmentioning

confidence: 99%

“…Successful results depend on anatomic restoration of joint congruity and alignment of the lower extremity with stable fixation allowing early mobilization [7][8][9] . In addition, preservation of the soft-tissue envelope is also important for minimizing the risk of soft tissue complications 10 . For monocondylar tibial plateau fractures, one of the most challenging and crucial processes is anatomic restoration of the displaced intra-articular fragments which are depressed downwards into the metaphysis.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Chang

et al. 2018

Orthopaedic Surgery

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Instead of extensive dissection of soft tissue around the fracture site, percutaneous techniques have unique advantages in managing displaced fragments, including preservation of soft tissues, less blood loss, lower risk of complications, and earlier functional rehabilitation. However, there are few systematic reviews on the effects of percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures. A systematic search of Cochrane, EMBASE, and MED-LINE databases was performed for all publicly available data in March 2017 regarding the use of PRIF in treating monocondylar tibial plateau fractures. Basic information of included articles, surgical information, clinical outcomes, and concomitant soft tissue injuries were collected for analysis. Finally, a total of 20 articles including 561 patients were retrieved. Traffic accident was the most common cause of injury. Percutaneous techniques using bone tamp reduction were described in all studies. The majority (≥85%) of patients were classified as excellent or good according to clinical and radiological Rasmussen scores. The overall complication rate was 6.6%, with loss of reduction the most frequent complication with an incidence of 2.4%. This systematic review indicated that PRIF was an optimal alternative that physicians should consider for the treatment of monocondylar tibial plateau fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Percutaneous Reduction and Internal Fixation for Monocondylar Fractures of Tibial Plateau: A Systematic Review

Chang

et al. 2018

Orthopaedic Surgery

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“…Arthroscopic reduction and internal fixation are recommended as a safe and reliable method for treatment of tibia plateau fractures. 4 With arthroscopic-assisted techniques, the reduction of the depressed fragment can be performed indirectly without excessive dissection.Inherent advantages of arthroscopic-assisted techniques include less soft tissue stripping and lesser wound site complications. To avoid these complications, arthroscopic-assisted techniques that involve restoration of the depressed joint surface and grafting under the …”

mentioning

confidence: 99%

mentioning

confidence: 99%

“…To eliminate the problems related to the open techniques, many authors recommended minimally invasive reduction and stabilization techniques such as isolated lateral plating with medial external fixation, hybrid external fixation, tensionedwire fixation, and percutaneous reduction. [2][3][4] In Schatzker type III tibia plateau fractures, exploration of the fracture site is challenging because the lateral plateau is not displaced. Arthroscopic reduction and internal fixation are recommended as a safe and reliable method for treatment of tibia plateau fractures.…”

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confidence: 99%

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Arthroscopic Technique for Treatment of Schatzker Type III Tibia Plateau Fractures Without Fluoroscopy

Ozkut

Poyanlı

Erçin

et al. 2017

Arthroscopy Techniques

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Accurate reduction and maintenance of the stability with correct implant positioning is critical for surgical treatment of tibial plateau fractures. Our technique includes an arthroscopic reduction and fixation of Schatzker type III tibial plateau fractures with a bulls-eye screw placement without fluoroscopy control. With the arthroscopic guidance, an anterior cruciate ligament drill guide is placed and a K-wire sent to the midpoint of the depressed fragment through the guide at a 40 angle to the coronal axis of the tibia. A tunnel is created with the drill over the K-wire. The depressed fragment is further augmented with gentle impacts over the K-wire. After arthroscopic reduction control, an appropriatesized iliac graft is pushed until it is below the depressed fragment. The targeting device is adjusted at 130 so that it is parallel to the joint line and a K-wire sent through the device so that it would pass just below the graft. The graft is then supported with cannulated screws sent over the K-wire. This technique provides an arthroscopic reduction of the chondral surface and precise placement of the rafting screws without fluoroscopy.L ong-term clinical results of tibial plate fractures are dependent on the quality of the intra-articular reduction of the articular surface. 1 Excessive dissection of the injured soft tissue envelope and devitalization of bone fragments are the primary concerns of the open techniques. To eliminate the problems related to the open techniques, many authors recommended minimally invasive reduction and stabilization techniques such as isolated lateral plating with medial external fixation, hybrid external fixation, tensionedwire fixation, and percutaneous reduction. [2][3][4] In Schatzker type III tibia plateau fractures, exploration of the fracture site is challenging because the lateral plateau is not displaced. Arthroscopic reduction and internal fixation are recommended as a safe and reliable method for treatment of tibia plateau fractures. 4 With arthroscopic-assisted techniques, the reduction of the depressed fragment can be performed indirectly without excessive dissection.Inherent advantages of arthroscopic-assisted techniques include less soft tissue stripping and lesser wound site complications. To avoid these complications, arthroscopic-assisted techniques that involve restoration of the depressed joint surface and grafting under the

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