Arthroscopic-assisted Reduction Research Articles

Arthroscopic Assisted Reduction of Talus Fractures Leads to Improved Clinical Outcomes at Mid- Term Follow-Up

Introduction/Purpose: Talus fracture is an uncommon and challenging pathology to treat due to its relationship with articular cartilage, ligamentous network, and avascular nature. The purpose of this systematic review was to evaluate the clinical outcomes after arthroscopic talar fracture fixation, compare to conventional open reduction and internal fixation (ORIF), and analyze the quality and level of evidence of the included studies. Methods: A systematic review of the MEDLINE, EMBASE, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in June 2023. Articles were included if they evaluated outcomes following arthroscopic treatment of talus fractures, were written in English, were peer-reviewed, had a minimum of 2 patients per cohort, had human patients, and had a minimum 6-month follow-up. Inclusion criteria consisted of: Studies reporting clinical data following arthroscopy for the treatment of talus fractures were included and assessed. Results: Seven studies were analyzed, including 4 case series, 1 retrospective cohort, and 2 retrospective comparative studies. 237 patients treated with arthroscopic assisted reduction were compared to 76 patients treated with ORIF. Amongst arthroscopically treated patients, the AOFAS score improved from 71.2 ± 5.2 preoperatively to 89.9 ± 4.3 postoperatively. The SF-36 score improved from 73.2 ± 30.3 preoperatively to 104.5 ± 19.3 postoperatively. In total, 6 complications (3.0%) were observed in arthroscopically treated patients, of which the most common was peri-talar osteoarthritis in 2 patients (0.84%). In comparative cohorts, ORIF patients experienced a 13.0% complication rate in 6 patients (talar necrosis, malunion, nonunion, infection, and post-traumatic arthritis), compared to 2.2% in 1 patient (malunion) in the arthroscopic cohort. Conclusion: This study demonstrates that arthroscopic assisted reduction of talar fractures results in good clinical outcomes with lower complication rates. This minimally invasive approach had lower complications than ORIF, with no cases of talar necrosis and decreased postoperative traumatic arthritis. This technique provides adequate exposure without additional osteotomy, while decreasing trauma to local anatomical trauma, minimizing the risk of postoperative complications, and improving fracture healing assessment of concomitant lesions. These findings indicate arthroscopic treatment of talus fractures is an efficacious and safe procedure with comparable or improved clinical and postoperative outcomes as compared to conventional ORIF.

Tibial Spine Avulsion Fracture Fixation Using a Re-tensionable All-Suture Construct

Tibial spine avulsion injuries, including fractures, are a variant of anterior cruciate ligament injuries. Treatment historically consisted of open reduction and internal fixation of the avulsion fracture, with anterior cruciate ligament reconstruction considered in cases of failed open reduction and internal fixation or residual laxity. However, improved instrumentation has led to the advancement of various arthroscopic techniques for addressing these injuries. The emergence of newer implants designed for all-suture fixation has also overcome the limitations associated with screw fixation, such as hardware-related complications, challenges in treating comminuted fractures, and potential physeal injury. The purpose of this article is to describe a technique consisting of arthroscopic-assisted reduction and internal fixation of a tibial spine avulsion fracture with a re-tensionable all-suture–based construct using multiple looped cinch stitches and a cortical suspensory suture button device.

Percutaneous elevation of proximal tibia depressed fractures using modified new instrument

Proximal tibia depression fracture often occur isolated or in conjunction with complex fracture presentations and elevation of such depression is required to retard arthritis in long term. Conventional open reduction by sub meniscal approach has many percutaneous alternatives from arthroscopy assisted reduction to balloon tibioplasty. Few authors even reported usage of PCL jig and percutaneous pins to elevate, while the primary author has previously described an instrument to elevate the depressed fragment percutaneously. With the shortcomings of the same instrument, authors have designed modifications in the same to address anterior and posterior extensions of depression without widening the metaphyseal window. In this article, we describe the size and concept of the modified design and its efficacy to address depression injuries.

Surgical outcomes and complication rates of arthroscopic-assisted fixation versus open fixation for coronoid fractures: A systematic review and meta-analysis

Background Coronoid fractures often occur with complex elbow dislocations, accounting for 15% of elbow fractures. The effectiveness of open reduction internal fixation (ORIF) versus arthroscopic-assisted reduction internal fixation (ARIF) surgeries for coronoid fractures remains uncertain. This study aimed to compare the outcomes of these two surgical approaches in treating varus posteromedial injuries. Methods This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO. The primary outcomes assessed in this study were the functional outcomes measured by the Mayo Elbow Performance Score (MEPS) and the complications associated with each surgical approach. Results Analysis of the data from 759 patients included in this study revealed that the mean postoperative MEPS score was higher in the ARIF group compared to the ORIF group (97.5 Vs. 90.7), with the mean improvement in MEPS was 16.6 points (19 for ORIF and 14.3 for ARIF). The complication rate in the ORIF group was 24.6%, while the ARIF group reported a complication rate of 6%. Conclusion This study suggests that ARIF surgery can yield comparable and promising outcomes to ORIF surgery for coronoid fractures. Level of evidence IV

The Clinicoradiological Outcome of Arthroscopic-assisted Reduction and Internal Fixation of Tibial Plateau Fractures

Abstract Background: The fractures of the tibial plateau are intraarticular fractures accounting for 1% of all fractures. Surgical management of such fractures is often challenging because they require anatomical reduction and stable fixation, which will allow for early rehabilitation. Arthroscopy has evolved nowadays and arthroscopically assisted reduction and fixation is a good option among the available surgical options. Materials and Methods: This prospective study included 50 cases of tibial plateau fractures managed surgically by arthroscopic-assisted reduction and fixation starting from August 2019 to December 2022. Results: The patients were 39 years old on average and were mostly men (58%). The right knee was the most usually injured (53%), and the most common cause of injury (41.5%) was a fall from a height. The majority of these fractures (44.5%) belonged to Schatzker type 2, followed by type 1 (37%) and type 3 (18.5%). The average time to complete weight-bearing for a Schatzker type I fracture was 10 weeks, 11.5 weeks for a type II fracture, and 13.5 weeks for a type III fracture. The average time to union for Schatzker type I was 13 weeks, 15.5 weeks for type II, and 16 weeks for type III. The mean clinical and radiological scores using the modified Rasmussen criteria were 26.3 and 7.3, respectively. Conclusions: A good surgical outcome of tibial plateau fracture is acquired when anatomic articular surface reconstruction with the elevation of depressed bone fragment is combined with rigid stable fixation, which permits early rehabilitation. Arthroscopy helps in achieving these goals by providing a good visualization of the articular surfaces, adequate fracture reduction, and anatomical restoration of the joint surface and aids in thorough joint lavage to remove the intraarticular debris.

FUNCTIONAL OUTCOME OF FIXATION OF TIBIA SCHATZKER TYPE II AND TYPE III FRACTURES UNDER ARTHROSCOPIC GUIDANCE

The tibial plateau fracture is a common type of orthopaedic fracture. An alternative to open reduction and internal fixation (ORIF) is arthroscopic-assisted reduction and internal fixation, which provides direct visualisation of the articular surface of the plateau, evaluation of the reduction of the articular surface, and management of any intra-articular pathology that may be associated with the reduction of the articular surface. This study aimed to determine the functional outcome of patients who received tibial fixation under arthroscopic supervision for Schatzker's Type II and III tibial fractures. The research was conducted over six months in the Orthopaedic Surgical Department at Jinnah Hospital in Lahore from November 17, 2022, to May 17, 2023. Sixty patients met the inclusion criteria were recruited after obtaining written informed permission. A clinical and historical examination of each patient's knees was conducted, followed by arthroscopy-guided internal reduction and repair of the tibial fracture under general anaesthesia. All patients received a post-operative rehabilitation regimen. At the three-month follow-up, standing AP radiographs were taken to examine the general alignment of the limbs, and Rasmussen score results were recorded. The average age of the patients was 46 years, and 63.3% were men and 36.7% were women. Schatzker grades II and III tibial plateau fractures were present in 53.3% and 46.7% of the patients, respectively. The mean Rasmussen clinical score was 27.33, indicating that 50 out of 60 patients had excellent recovery, nine out of 60 patients had good recovery, and one out of 60 patients had fair recovery. The mean Rasmussen radiological score was 7.36, indicating that 48 out of 60 patients had outstanding recovery, 11 out of 60 patients had good recovery, and one out of 60 patients had fair recovery. In conclusion, arthroscopic-assisted reduction and internal fixation is a good technique for treating young patients with Schatzker grades II-III tibial plateau fractures, and it enables control of co-existing injuries of intra-articular soft tissues, leading to faster recovery and greater patient satisfaction. However, having expertise in trauma and arthroscopic methods is important to carry out the procedure correctly.

Capitellum Fracture: Surgical Exposure and Fixation Strategies

Fractures of the capitellum are uncommon, often accompanied by radial head or lateral collateral ligament injuries, and typically treated operatively. Operative fixation is often technically challenging due to limited surgical windows, limited bone stock for fixation, its articular nature, and fracture extension into the trochlea or condyles. The goal of treatment is stable internal fixation to permit an early range of motion. Aside from open reduction internal fixation (ORIF), alternative treatment options include fragment excision and arthroscopic assisted reduction and fixation. Here we detail our preferred approach to treat capitellum fractures, including, preoperative planning, surgical anatomy, surgical setup and technique utilizing a posterior utility incision and olecranon osteotomy, postoperative care, and avoidance of potential complications.

Technique for Minimally Invasive, Arthroscopic-assisted Distal Radius Fracture Fixation.

Distal radius fractures are common injuries that often require surgical intervention. Commonly, these fractures are fixed using open reduction internal fixation with plating and screws. This often requires a more extensive soft tissue dissection and exposure. In contrast for certain cases, percutaneous headless compression screws may be appropriate. We present a technique for minimally invasive arthroscopic-assisted reduction and percutaneous screw fixation with an extremity traction device. A case is provided to demonstrate the technique as a viable option for the treatment of intra-articular distal radius fractures.

Arthroscopic-assisted Distal Radius Fracture Fixation for Dorsoulnar Corner Fragments Using a Locked, Hooked Kirschner-Wire Technique

Abstract Background: Distal radius fractures with dorso-ulnar corner fragments (DUC) pose a surgical challenge due to limited visualization and the risk of hardware prominence. Traditional approaches often result in inadequate reduction and fixation, leading to suboptimal clinical outcomes. Description of Technique: In this study, we introduce an arthroscopic-assisted approach for the fixation of distal radius fractures with DUC fragments. The technique utilizes locked, hooked K-wires to provide a low-profile dorsal capturing mechanism. We outline the step-by-step procedure, which includes pre-operative planning, volar plate application, and arthroscopic reduction of DUC fragments. Patients and Methods: We applied this technique to a 60-year-old female patient with an unstable intra-articular distal radius fracture and a DUC fragment. Closed reduction was initially attempted, followed by arthroscopic-assisted reduction and internal fixation using the locked, hooked K-wire technique. Results: Our technique has demonstrated its ability to withstand early movement rehabilitation protocols without fixation loss, enabling early mobilization. A custom thermoplastic splint was worn for 6 weeks, with favorable supination/pronation and wrist flexion/extension outcomes at clinical review. Conclusions: Arthroscopic-assisted fixation with locked, hooked K-wires offers a reliable solution for accurately reducing challenging DUC fragments in distal radius fractures. This approach complements standard distal radius fixation systems, providing a low-profile dorsal capturing mechanism and addressing the issue of hardware prominence, ultimately improving clinical outcomes.

A novel technique for treating simple transverse patellar fractures using cannulated screws: a cadaveric and clinical study

BackgroundTension band wiring (TBW) has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as large incision, implant irritation, and need for subsequent implant removal. Here, we propose a novel technique using closed reduction and percutaneous fixation with three cannulated screws (TCS), which may be an alternative to this established conventional technique. Although some researchers have proposed alternative methods including closed reduction and cannulated screw fixation, with or without additional wires through the screws, and arthroscopic-assisted reduction and fixation, there are few studies that focus on the biomechanical stability of percutaneous fixation using only cannulated screws. Thus, the purpose of this study was to evaluate TCS versus TBW for simple transverse patellar fractures in cadaveric and patients' level, aiming to determine whether TCS show superiority over TBW in terms of biomechanical stability in a cadaveric study with benign clinical feasibility and outcomes in patients.MethodsWe conducted a cadaveric study with 15 knee specimens that had simple transverse patellar fractures. We used two fixation techniques: TBW (group A, n = 6) and TCS (group B, n = 9). We applied sinusoidal forces (25 N–125 N) at 1/5 Hz and 90° knee flexion to simulate knee movement. We compared the displacements at the fracture site between the two groups. We also used the same technique in a total of 23 patients and followed up them for at least 1 year.ResultsTCS demonstrated favourable biomechanical stability in the cadaveric study. The technique also performed excellently in terms of postoperative pain, knee function recovery, and complication rates during the follow-up period.ConclusionsThe technique provides a surgical treatment option with small incisions, minimal soft tissue irritation, and possibly lower removal rate of bothersome material.

All-Arthroscopic Management of Locked Posterior Shoulder Dislocation: Reduction Under Direct Visualization and Treatment of Intra-articular Pathologies

Locked posterior shoulder dislocation (LPSD) is a rare condition often overlooked. In most cases, the humeral head remains stuck behind the glenoid, causing an impression fracture in 40% to 90% of LPSD cases, known as a reverse Hill-Sachs lesion. The condition also affects the posterior capsulolabral complex and leads to the formation of scar tissue under the coracoid and subscapularis tendon, making it challenging to reduce without surgery. Although open treatment has been successful, it does not address the posterior capsulolabral complex. Arthroscopic-assisted reduction provides a more detailed view and better exposure to the posterior structures. This article details a reproducible arthroscopic surgical technique for treating the locked dislocation and all intra-articular pathology in a single-stage procedure for patients with less than 25% reverse Hill-Sachs bone loss.

Arthroscopy-assisted reduction and simultaneous robotic-assisted screw placement in the treatment of fractures of the posterior talar process.

A fracture of the posterior talar process is easily missed because of its hidden position. Inappropriate treatment is likely to result in complications, such as nonunion of the fracture and traumatic arthritis. This study evaluated the outcomes of arthroscopy-assisted reduction combined with robotic-assisted screw placement in the treatment of fractures of the posterior talar process. The clinical data for nine patients who underwent surgical treatment of a fracture of the posterior talar process at our institution between September 2017 and January 2021 were retrospectively reviewed. Arthroscopy-assisted reduction of the fracture was performed, and a cannulated screw was placed using three-dimensional orthopedic robotic-assisted navigation. The patients (seven men, two women) had a mean age of 36.33 ± 9.77years and were followed up for 21 ± 5.43months. The operation time was 106.67 ± 24.5min with blood loss of 47.78 ± 9.05ml. Primary healing was obtained in all cases, and no patient sustained a nerve or tendon injury, had fracture nonunion, or developed talar osteonecrosis. One patient developed subtalar arthritis, for which subtalar joint fusion was performed; pain was markedly less severe after cleaning. Arthroscopy-assisted reduction and robotic-assisted screw placement have the advantages of visualization of fracture reduction, minimal injury, and precise screw placement in the treatment of fractures of the posterior talar process.

Arthroscopic-assisted reduction and internal fixation for complex tibial plateau fracture: radiographic and clinical outcomes with 2- to 15-year follow-up

BackgroundTo investigate the radiologic and prognostic outcomes after using arthroscopic-assisted reduction and internal fixation (ARIF) in complex tibial plateau fractures with mid- to long-term follow-up.MethodsThis retrospective study reviewed complex tibial plateau fractures that underwent ARIF from 1999 to 2019. Radiologic outcomes, including tibial plateau angle (TPA), posterior slope angle (PSA), Kellgren–Lawrence classification and Rasmussen radiologic assessment, were measured and evaluated. The prognosis and complications were assessed by the Rasmussen clinical assessment with a minimum follow-up of 2 years.ResultsNinety-two consecutive patients (mean age: 46.9 years) with a mean follow-up of 74.8 months (24–180) were included in our series. Using AO classification, there were 20 type C1 fractures, 21 type C2 fractures, and 51 type C3 fractures. All the fractures achieved solid union. TPA was maintained well on average at the last follow-up and showed no significant difference compared to postoperatively (p = 0.208). In the sagittal plane, the mean PSA increased from 9.3 ± 2.9° to 9.6 ± 3.1° (p = 0.092). A statistically significant increase in PSA was also noted in the C3 group (p = 0.044). Superficial or deep infection was noted in 4 cases (4.3%), and total knee arthroplasty (TKA) was performed in 2 cases (2.2%) due to grade 4 osteoarthritis (OA). Ninety (97.8%) and 89 (96.7%) patients had good or excellent results in the Rasmussen radiologic assessment and Rasmussen clinical assessment, respectively.ConclusionsThe complex tibial plateau fracture could be treated successfully using arthroscopy-assisted reduction and internal fixation. Most patients achieve excellent and good clinical outcomes with low complication rates. In our experience, a higher incidence of increased slope was noted, especially in type C3 fractures. Reduction of the posterior fragment should be done cautiously during the operation.Levels of evidenceLevel III.

Arthroscopic Assisted Anterior Cruciate Ligament Tibial Spine Avulsion Reduction and Cortical Button Fixation

Tibial spine avulsion fractures, or tibial eminence fractures, are intra-articular knee injuries that affect the bony attachment of the anterior cruciate ligament (ACL). It is commonly seen in children and adolescents aged 8 to 15 years old and can be caused by noncontact pivot shift injuries or by traumatic hyperextension knee injuries, as seen in adult ACL patients. A thorough history and physical exam is important in these patients alongside proper imaging that will confirm the diagnosis of a tibial spine avulsion. Proper imaging may also demonstrate other associated conditions or injuries to the cartilage, meniscus, or ligamentous structures. Following diagnosis, treatment can be both nonoperative versus operative, depending upon the degree of displacement and reducibility of the fragment, as well as other concomitant injuries. For nondisplaced or minimally displaced, and reducible injuries, the patient can be immobilized in full extension for several weeks. For displaced fragments that are unable to be reduced by closed methods, open reduction internal fixation or arthroscopic fixation is recommended. In this Technical Note, we describe an arthroscopy-assisted reduction and internal fixation with suture tape through 2 transtibial tunnels with a cortical suture button fixation technique.

A Novel Mini-Invasive Technique of Arthroscopic-Assisted Reduction and Robot-Assisted Fixation for Trans-Scaphoid Perilunate Fracture Dislocations.

Perilunate injuries are rare but devastating carpal injuries. The treatment of perilunate injuries remains challenging and contentious. This study aims to describe a novel mini-invasive surgical technique of arthroscopic-assisted reduction and robot-assisted fixation for the treatment of trans-scaphoid perilunate fracture dislocations (PLFDs). We retrospectively reviewed patients with PLFDs after surgical treatment from February 2021 to March 2021. The patients underwent arthroscopic-assisted precise reduction and robot-assisted headless screw fixation. Times of guide wire placement were recorded intraoperatively. Periodic follow-up was performed until union of scaphoid fracture was confirmed. Range of motion of the wrist, grip strength, the Visual Analog Scale (VAS) score, the Mayo Wrist Score, the Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) score, the Patient-Rated Wrist Evaluation (PRWE), and osteoarthritis were evaluated at the final follow-up. Two male patients presenting with PLFDs with an average age of 24.5 years old (32 and 17 years) were included in this study. Intraoperatively, anatomic reduction of the scaphoid fracture was achieved under arthroscopic guidance. A robotic-assisted single-attempt guidewire insertion was performed for scaphoid fracture and lunotriquetral interval. The CT scans at 8 and 12 weeks showed the union of the scaphoid fracture. At final mean follow-up of 13.5 months, the extension, radial-ulnar deviation, and pronation-supination were consistent with the contralateral side in both patients. One patient experienced mild limited range of motion with the flexion 46° of the injured wrist compared with 81°of the contralateral wrist. The VAS score was 0 and 2. The grip strength was 32 and 26 kg compared with 24 and 42 kg of the contralateral wrist. The PRWE score was 13 and 10 and the QuickDASH score was 2 and 7. The Mayo Wrist Score was 100 and 65. No sign of osteoarthritis was found at the last follow-up. Arthroscopic-assisted reduction and robot-assisted fixation is a viable and promising alternative for the treatment of perilunate fracture dislocations. This technique allows precise reduction and accurate placement of the K-wires/screws into the carpal bones through the optimal biomechanical paths.

Management and Complications of Condylar Fractures

Mandibular condylar fractures are frequently encountered maxillofacial traumatic injuries, representing a significant proportion of all fractures of the lower jaw. They are more common in young males and are typically caused by trauma to the face or jaw. The diagnosis begins with a thorough medical and dental history, followed by a clinical examination and radiographic imaging. With both surgical and nonsurgical methods available, there are differences in opinion regarding condylar fracture repair. Surgical options include open reduction and internal fixation (ORIF), closed reduction and internal fixation (CRIF), percutaneous reduction and internal fixation (PRIF), arthroscopy-assisted reduction and internal fixation (ARIF), and endoscopic-assisted reduction and internal fixation (ERIF). Non-surgical options include closed reduction, immobilization, and functional therapy. Complications can occur with both surgical and non-surgical approaches, and the timing of treatment should be based on the severity and complexity of the fracture, as well as the patient's overall health and individual circumstances. The longterm outcomes of mandibular condylar fracture management are generally favorable, but certain factors can influence the prognosis. Further research is needed to better understand how to optimally manage these injuries and improve clinical and surgical outcomes.

A Mid-Scapular Portal for Arthroscopic-Assisted Fixation of Severe Retraction Greater Tuberosity Avulsion Fracture

Chronic displaced greater tuberosity avulsion fracture of the humerus causes severe retraction of the rotator cuff and resorption of the avulsion fragment. Many treatment options can be considered to solve this problem and return the patient to function. The arthroscopic technique is very challenging to achieve a reduction of the rotator cuff and fixation of greater tuberosity with minimized soft-tissue damage. This Technical Note describes a portal for arthroscopic-assisted reduction and fixation in severe retracted greater tuberosity avulsion fracture. The technique is easy to release and fix chronic displaced greater tuberosity and could avoid unnecessary open surgery.

Features of arthroscopic-assisted reduction of tibial plateau fractures

Introduction. Surgical treatment of tibial condyle fractures have been little studied and it represents difficulties up to now. Aim. The aim of the present work was improvement of results of surgical treatment of tibial condyle fractures. Methods. Surgical treatment of tibial condyle fractures is done on total of 65 patients in the department of Sport trauma of Centre of traumatology and Orthopaedics arthroscopy. Results. Good and satisfactory outcomes were achieved in all the patients received arthroscopy treatment. The use of magnetic resonance imaging (MRI) and multislice computed tomography (MSCT) in the diagnosis of intra-articular fractures of the knee joint, and the analysis of their results contribute to the choice of the optimal surgical treatment. Arthroscopy of intra-articular fractures of the tibial condyles allows for an accurate diagnosis, visual control of the reduction, that is characterized by minimal surgical traumatism, minimal risk of infectious complications, leaves a minimal cosmetic defect, and helps to shorten the length of hospital stay and early rehabilitation of patients. Recommendation. Suggested methods are high effective and can be recommended in practical medicine.

[Arthroscopic-assisted fracture reduction combined with robot-navigated nail placement to treat talar neck fractures].

This study aims to explore the clinical efficacy of arthroscopic-assisted reduction combined with robot-navigated nail placement in the treatment of talar neck fractures. The clinical data of 13 patients with talar neck fracture in Xuzhou Benevolent Hospital from January 2018 to January 2021 were analyzed in the retrospective study. Among them, there were 9 males and 4 females, aged (36±12) years; there were 8 cases suffered on the right and 5 cases on the left. All patients were reset under arthroscopy and cannulated screws were placed in combination with three-dimensional navigation and positioning of orthopedic robot. The wounds and complications were observed in the postoperative follow-up. The activities of bilateral ankle dorsiflexion and plantar flexion were measured in the last follow-up. The visual analogue scale score (VAS) of pain in the affected feet before operation were compared with that at the last follow-up. The ankle and hind foot work energy scale of American Foot and Ankle Association (AOFAS) was used to assess the ankle function. The results showed that the wounds of 13 patients healed in one stage. The operation time was (95±45) min and the blood lose was (45±10) ml. All the patients were followed-up for (15.0±3.5) months. Two cases developed subtalar arthritis without talus necrosis and fracture nonunion. At the last follow-up, there was no significant difference in the dorsal extension and plantar flexion of the ankle between the affected side and the healthy side (25.8°±1.9° vs 26.2°±2.3°, 44.2°±2.7° vs 44.7°±2.8°, both P>0.05). The VAS score of pain in the affected foot at the last follow-up was 0.53±0.18, it was significantly lower than that before operation (0.87±0.29) (P<0.001). The mean AOFAS ankle and hind foot energy scale of the ankle function was 93.5 at the last follow-up. It's showed that treatment of talus neck fracture with arthroscopy assisted and robot guided nail placement is satisfactory and is worthy of clinical promotion.

Arthroscopic-Assisted Reduction of Depressed Lateral Tibial Plateau Fracture Using Precision Drill Guide and Fresh-Frozen Femoral Head Allograft

In the patient with osteoporosis, tibial plateau fractures can occur after high-energy trauma or low-energy trauma. Arthrosis will rapidly progress if the depressed articular surface is left untreated. Therefore, the depressed articular surface should be treated by anatomical reduction. This Technical Note describes an arthroscopic-assisted reduction depressed lateral tibial plateau fracture using a precision drill guide and fresh-frozen femoral head allograft.