Arthroscopic management of tibial plateau fractures: special techniques

Arthroscopic assessment and treatment of tibial plateau fractures has gained popularity in recent years. This article describes some maneuvers to facilitate the management of these fractures with the arthroscope. We use a 14-mm rounded curved periosteal elevator to manipulate fragments within the joint instead of using a probe. To facilitate visualization of fractures, we describe the use of loop sutures around the meniscus to retract the meniscus when there is a tear in the meniscus. We suggest the use of the arthroscope for directly viewing the interosseous space to be sure that any internal fixation devices remain outside the articular space. The use of these tactics will allow a faster, more accurate reduction with less radiation exposure in patients with displaced tibial plateau fractures.