• Title/Summary/Keyword: 골막거상기

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Arthroscopically-Assisted Reduction and Internal Fixation of Intra-Articular Fractures of the Lateral Tibial Plateau (관절면을 침범한 경골 외측 고평부 골절에 대한 관절경을 이용한 정복 및 내고정술)

  • Kim, Juhan;Kim, Dong Hwi;Lim, Jae-Hwan;Jang, Hyunwoong;Kim, Young Wook
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.227-236
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    • 2019
  • Purpose: To evaluate the results of tibial lateral plateau fractures using arthroscopic-assisted reduction and internal fixation without cortical window or bone grafts. Materials and Methods: From March 2009 to March 2017, 27 patients with Schatzker type II tibial plateau fractures with articular depression and displacement over 5 mm on a computed tomography (CT) scan, who were treated with arthroscopic reduction and internal fixation and followed-up for at least 18 months, were enrolled in this study. Under arthroscopic guidance, the depressed fracture fragment was reduced using a freer and fixed with 5.0 or 6.5 mm cannulated screws through the inframeniscal portal without a cortical window or bone graft. The clinical and radiological results were evaluated using a Rasmussen system. Second look arthroscopy was performed in thirteen patients during the implant removal operation. Results: All fractures healed completely with a mean union time of 8.7 weeks (range from 8 to 12 weeks). Twenty four patients had good to excellent clinical results and 25 patients had good to excellent radiological results according to the Rasmussen classification. A well-healed articular surface with fibrocartilage was also found in 13 cases with second look arthroscopy. The 8 cases on CT scan at outpatient department follow-up showed bone union without bone grafting. Conclusion: Arthroscopic-assisted fixation of tibial lateral plateau fractures is a useful method without a cortical window or bone graft that produces good clinical results.