Open Intrameniscal Examination and Reduction of Depressed Tibial Plateau Fracture

In the Schatzker classification, approximately 60.5% of tibial fractures can potentially involve depression fractures of the plateau, on average in types II, III, and IV, and are particularly prevalent among the elderly population. A significant challenge in managing these fractures is achieving optimal visualization of the depressed fracture segments during surgical intervention. Traditional management techniques include intraoperative fluoroscopy, submeniscal arthrotomy, and arthroscopic-guided reduction. However, each of these methods presents specific drawbacks: exposure to radiation, the requirement for advanced equipment, limited access to the fracture site, increased technical complexity, and the risk of damaging the meniscotibial ligaments. In light of these challenges, we describe a distinctive intrameniscal approach for the repair of depressed tibial plateau fractures. This technique effectively addresses the limitations of traditional methods by eliminating the necessity for intraoperative radiation, simplifying the surgical procedure, and preserving the integrity of the meniscotibial ligaments. Importantly, our approach maintains excellent visualization and surgical exposure, enhancing the overall efficacy and safety of the intervention.