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AGA2012-260
GRENZEN DER ARTROSKOPISCHEN-ASSISTIERTE PROXIMALEN TIBIA FRAKTUR
OSTEOSYNTHESE
LIMITS OF ARTHROSCOPY-ASSISTED TIBIAL PLATEAU FRACTURE OSTHEOSYNTHESIS
Authors
* Radu Prejbeanu 1st Orthopaedics and Traumatology Clinic, Timisoara, Romania
Dinu Vermesan 1st Orthopaedics and Traumatology Clinic, Timisoara, Romania
* Dan Crisan 1st Orthopaedics and Traumatology Clinic, Timisoara, Romania
Horia Haragus 1st Orthopaedics and Traumatology Clinic, Timisoara, Romania
Abstract
Fragstellung: Remnant postoperative intraarticular deformity is one the predictors of an unfavorable long term
result after a tibial plateau fracture. Intraoperative arthrosocopy provides direct fracture visualisation and
theoretically should be able to produce an anatomical reduction of the articular surface under direct visualisation
and direct evaluation of associated lesions of the meniscii, cartilage and ligaments. However not all tibial plateau
fractures can benefit from arthroscopy-assisted management, the pourpouse of this paper beeing to explore its
indications and limits.
Methodik: A literature review was made to search for the indications of arthroscopy-assisted ostheosynthesis.
We found an inconsistency in the indications, as some studies recomended the use of arthroscopy for low
Shatzker I-III and others used it for cominuted Shatzker V-VI fractures as well.
We then compared this to our case series of 15 fractures of the tibial plateau out of wich 5 were treated with
arthroscopic-assisted percutaneous ostheosynthesis.
Ergebnis: Adequate visualisation of the articular surface is possible in low energy Shatzker I and II fractures.
Percutaneous reduction for Shatzker III was harder more difficult a minimal open approach was used.
Schlussfolgerung: Arthroscopy-assisted ostheosynthesis provides a real benefit in percutaneous reduction of
the articular surface and for asociated lesions assesment in low energy Shatzker I and II fractures. Due to high
cominution and loss of limb alignement we found no real benefit in using arthroscopy for Shatzker V and VI
fractures. Randomized controlled trials are needed to asses the limits in the use of arthroscopy-assisted
techniques for treatment of intra-articular fractures.
Keywords
tibial plateau fracture arthrosopic-assisted limits indications
16.03.2012 234
Poster
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