Arthroscopic reduction and internal fixation of tibial plateau fractures in skiing

Arthroscopic reduction and internal fixation of tibial plateau fractures can facilitate restoration of articular congruity while permitting rigid fracture stabilization. Twenty-five patients who underwent arthroscpoic reduction and internal fixation of a tibial plateau fracture were reviewed. The average age of the patients was 45. At a mean followup of 24 months, 76% of patients rated their result as excellent and 16% as good. Eighty-four percent returned to full sporting activity. There were no episodes of nonunion, failure of fixation, wound infection, deep venous thrombosis, compartment syndrome, or arthrofibrosis. Preoperative fracture depression averaged 7.7 mm (range, 1-18 mm). Fracture depression at final followup averaged 0.8 mm (range, 0-5 mm). Sixty-four percent of patients had associated intraarticular injury diagnosed and treated at the time of arthroscopy. Arthroscopic reduction and internal fixation provides an accurate assessment of, and allows definitive treatment for, intraarticular injuries associated with tibial plateau fractures. The technique allows less soft tissue stripping than with traditional arthrotomy, better visualization of the articular surface, early return to physical activities, and obviates the need for meniscal detachment and repair.