Arthroscopic Reduction and Internal Fixation of Intra-articular Fractures of Lateral Tibial Plateau

관절면을 침범한 경골 외과 골절의 관절경적 정복 및 내고정술

  • Lee, Kwang-Won (Department of Orthopaedic Surgery, Eulji University Hospital) ;
  • Lee, Hang-Ho (Department of Orthopaedic Surgery, Eulji University Hospital) ;
  • Yang, Dong-Hyun (Department of Orthopaedic Surgery, Eulji University Hospital) ;
  • Choy, Won-Sik (Department of Orthopaedic Surgery, Eulji University Hospital)
  • 이광원 (을지의과대학 정형외과학교실) ;
  • 이항호 (을지의과대학 정형외과학교실) ;
  • 양동현 (을지의과대학 정형외과학교실) ;
  • 최원식 (을지의과대학 정형외과학교실)
  • Published : 2006.06.30

Abstract

Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.