The value of arthroscopy in joint fractures of the lower limb

Abstract

Introduction: Lower extremity joint fractures are common and require precise management to avoid complications. Arthroscopy offers advantages in terms of precise control, detection of associated lesions and minimally invasive surgery, thus improving post-operative outcomes. Material and methods: The retrospective study focused on 51 cases of joint fractures of the lower limb treated by arthroscopy at the Ibn Rochd University Hospital over a period of four years including : 30 ankle fractures, 20 knee fractures and a single case of hip joint fracture. The pathological study was carried out on a radiological analysis and the fractures were then classified according to the appropriate classification. Results: In the first case, a 16-year-old adolescent victim of a road accident suffered a postero-superior dislocation of the left hip, requiring emergency reduction followed by arthroscopy to remove three intra-articular foreign bodies. For the second case, knee joint fractures were observed in adults aged 20 to 55 years, mainly men, following road accidents. Surgical treatment included fracture reduction and internal fixation, with satisfactory postoperative results. Finally, in the third case, ankle joint fractures were observed in young and active adults, with a male predominance. Surgical treatment, carried out on average four days after the accident, also consisted of reduction of the fractures followed by osteosynthesis. Postoperative results were very positive, with rapid functional recovery and no complications reported. Discussion: Joint fractures of the lower limb include those of the hip, tibial plateaus and ankle. For hip fractures, more common in young adults, reduction of dislocations is crucial, often carried out under general anesthesia. Tibial plateau fractures, observed mainly in young men, require precise detection of associated lesions, which are often difficult to identify initially. As for ankle fractures, common in active adults, precise imaging, such as CT, is recommended to guide treatment, including arthroscopic screw fixation in cases of syndesmosis damage. Conclusion: Joint fractures of the lower limb are complex and require careful evaluation. Arthroscopy has revolutionized their treatment by providing precise assessment, direct reduction and treatment of associated lesions allowing rapid recovery and reduced post-operative risks compared to conventional surgery.