Arthroscopic reduction and internal fixation of tibial plateau fractures in skiing

Arthroscopic reduction and interval fixation of tibial plateau fractures ca n facilitate restoration of articular congruity while permitting rigid frac ture stabilization. Twenty-five patients who underwent arthroscpoic reducti on and internal fixation of a tibial plateau fracture were reviewed. The av erage age of the patients was 45. At a mean followup of 24 months, 76% of p atients rated their result as excellent and 16% as good. Eighty-four percen t returned to full sporting activity. There were no episodes of nonunion, f ailure of fixation, wound infection, deep venous thrombosis, compartment sy ndrome, or arthrofibrosis. Preoperative fracture depression averaged 7.7 mm (range, 1-18 mm). Fracture depression at final followup averaged 0.8 mm (r ange, 05 mm). Sixty-four percent of patients had associated intraarticular injury diagnosed and treated at the time of arthroscopy. Arthroscopic reduc tion and internal fixation provides an accurate assessment of, and allows d efinitive treatment for, intraarticular injuries associated with tibial pla teau fractures. The technique allows less soft tissue stripping than with t raditional arthrotomy, better visualization of the articular surface, early return to physical activities, and obviates the need for meniscal detachme nt and repair.