Arthroscopic reduction and internal fixation (ARIF) of lateral tibial plateau fractures

Arthroscopic reduction and internal fixation of tibial plateau fractures ha s been well documented over the last 15 years. Better visualization, less t raumatic surgery, reconstruction of accompanying injuries and early mobiliz ation have encouraged arthroscopic surgeons to use this technique more wide ly. With experience, surgeons became more comfortable in using arthroscopy- assisted surgery not only in split fractures of the lateral tibial plateau (41-B1) but also in more complex tibial and femoral fractures. In this stud y, 31 patients with intra-articular fractures of the lateral tibial plateau were operated on between 1991 and 1996. The fractures were classified as f ollows: x12 AO-type B1, x7 B2, x10 B3, x2 C3. Diagnostic arthroscopy and re pair of soft tissue injuries was followed by arthroscopic reduction in all patients and supplemented with internal fixation in 25 patients. Postoperat ively, an aggressive physical therapy regimen was performed with immediate mobilization and early partial weight bearing. All patients were examined f or follow-up after 15-32 months (mean 25.1). In all cases the fractures wer e stable and allowed full weight-bearing. At follow-up, 25 patients had ana tomic reduction. Anatomical reduction cannot be restored in all cases of op en reconstruction because of cartilage defects. Fracture reduction using ar throscopic techniques is a suitable alternative for joint fracture repair b ecause additional soft tissue damage can be minimized.