REVIEW OF INTRA-OPERATIVE TECHNIQUES TO ASSESS REDUCTION QUALITY IN TIBIAL PLATEAU FRACTURES

Achieving anatomical reduction in tibial plateau fractures is essential to restore joint congruity and minimize long-term complications. Intraoperative assessment remains challenging, especially in complex fracture patterns, prompting the evolution of various imaging and adjunctive techniques. This narrative review summarizes advancements in intraoperative tools used for evaluating reduction in tibial plateau fractures. Techniques discussed include 2D fluoroscopy, intraoperative 3D imaging, arthroscopy, and emerging adjuncts such as 3D printing and cone-beam CT. We conducted a targeted literature search across PubMed, Embase, and Scopus (2000-2025) to identify studies reporting on the clinical application, diagnostic utility, and limitations of intraoperative imaging modalities in tibial plateau fracture management. 2D fluoroscopy remains widely used but is limited in detecting subtle incongruities. Intraoperative 3D imaging enhances accuracy and may reduce reoperations. Arthroscopy offers direct joint visualization, especially useful for assessing depression and posterior injuries. Emerging tools like 3D printing and cone-beam CT present novel intraoperative aids but require further validation. This review provides a consolidated overview of intraoperative strategies described in the literature. By highlighting the current capabilities and limitations of available technologies, we aim to inform ongoing clinical practice and future directions in fracture management.