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FRACTURES OF THE TIBIAL PLATEAU. ARTHROSCOPIC TREATMENT. SIX-YEAR FOLLOW-UP



Abstract

Introduction and purpose: Fractures of the tibial plateau account for 1% of the total. Among them, 55–70% involve the lateral plateau with differences in separation and subsidence. Minimally invasive osteosynthesis under arthroscopic control increases the indications in these cases. Our purpose is to assess the long-term clinical and radiological outcomes.

Materials and methods: We carried out a retrospective analysis of the medium-term results of closed fractures of the tibial plateau treated with arthroscopic reduction and percutaneous fixation with cannulated screws. A series of 32 patients with displaced fractures of the tibial plateau underwent surgery between 1993 and 2004. We used the AO classification. We analysed the clinical, functional and radiological results.

Results: The mean follow-up was 6 years. We treated 12 type 41B1, 7 type 41B21, 5 type 41B22, 7 type 41B31 and 1 type 41B12. All the fractures were consolidated and 79.1% had anatomical reduction. External meniscal injuries that could be sutured were present In 11 cases (34.3%). Joint balance was complete in 24 knees. According to the Lysholm scale 23 had an excellent outcome and 9 good. One case presented infection of the surgical wound, which was resolved by surgical debridement and antibiotic therapy.

Conclusions: The results suggest that this is a good method for treating selected fractures of the tibial plateau.

The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain