Abstract
BackgroundThis study aims to explore if the arthroscopically assisted reduction and internal fixation (ARIF) technique is superior to the traditional open reduction and internal fixation (ORIF) technique in the treatment of tibial lateral plateau fractures.MethodsForty patients with tibial plateau fractures (Schatzker type I–III) treated with ARIF or ORIF from 2012 to 2017 were included in this retrospective study. All patients received pre-operative radiographs and CT scans. The patients were divided into two groups (ARIF or ORIF). All patients had a minimum follow-up of 12 months and an average follow-up of 44.4 months. The clinical and radiographic outcomes were evaluated according to the Knee Society Score (KSS) and the modified Rasmussen radiological score.ResultsSatisfactory clinical and radiological results were found in 39 out of 40 (97.5%) patients. KSS and modified Rasmussen radiological score were significantly better in ARIF group. The mean KSS was 92.37 (± 6.3) for the ARIF group and 86.29 (± 11.54) for the ORIF group (p < 0.05). The mean modified Rasmussen radiographic score was 8.42 (± 2.24) for the ARIF group and 7.33 (± 1.83) for the ORIF group (p = 0.104). Worst clinical and radiological results were related to concomitant intra-articular lesions (p < 0.05). Meniscal tears were found and treated in 17 out of 40 (42.5%) patients. The overall complication rate was 10%.ConclusionsBoth ARIF and ORIF provided a satisfactory outcome for the treatment of Schatzker I–III tibial plateau fractures. However, ARIF led to better clinical results than ORIF. No statistically significant differences were found in perioperative complications, radiological results, and post-traumatic knee osteoarthritis.Level of evidenceLevel III
Highlights
Tibial plateau fractures are articular lesions that typically involve either active young patients after high-energy trauma or older osteoporotic patients [1,2,3]
Material and methods We retrospectively reviewed a total of 59 consecutive patients with lateral tibial plateau fractures (Schatzker type I–III) surgically treated either by Arthroscopically assisted reduction and internal fixation (ARIF) or open reduction and internal fixation (ORIF) in our Department between January 2012 and December 2017
A total of 40 patients with Schatzker type I, II, and III tibial plateau fractures treated with ARIF or ORIF were evaluated
Summary
Tibial plateau fractures are articular lesions that typically involve either active young patients after high-energy trauma or older osteoporotic patients [1,2,3]. Schatzker type I–III fractures involve the lateral tibial plateau and traditionally were treated with open reduction and internal fixation (ORIF) through an anterolateral approach [8]. It requires extensive soft tissue dissection and increased risk of post-operative complications has been reported (e.g., infections, hematomas, surgical wound dehiscence, and wound necrosis) [9, 10] even when minimally invasive techniques were proposed for low-grade lateral tibial plateau fractures [11]. Assisted reduction and internal fixation (ARIF), first described by Caspari et al [12] and Jennings [13], rapidly spread in the last decades as an alternative treatment for low-grade lateral tibial plateau fractures. This study aims to explore if the arthroscopically assisted reduction and internal fixation (ARIF) technique is superior to the traditional open reduction and internal fixation (ORIF) technique in the treatment of tibial lateral plateau fractures
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