Andrianus Jeffry, Akbar Muhammad Rifqi Farizan, Yahya Farrel Aqila
Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Department of Orthopaedics and Traumatology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Int J Surg Case Rep. 2024 Sep;122:110107. doi: 10.1016/j.ijscr.2024.110107. Epub 2024 Jul 31.
One percent of adult fractures are tibial plateau fractures, but can represent significant morbidity for patients. Achieving anatomic reduction of the articular surface, adequate alignment, stable fixation consistent with early mobilization, and minimal soft tissue injury are the key goals of treatment. Compared to open reduction and internal fixation, the decreased invasiveness of arthroscopy-assisted percutaneous fixation translates into decreased morbidity rates.
A 35-year-old woman lost control of motorcycle and landed on her left knee. Immediate pain in her left knee and was unable to ambulate or move her knee. Initial radiographs showed a depressed lateral tibial plateau fracture and from computed tomography (CT) scan showed a depressed posterolateral tibial plateau fracture with incongruence of his joint space. Classifying the injury as a Schatzker type 2 tibial plateau fracture She underwent an arthroscopic-assisted open reduction internal fixation of her lateral tibial plateau.
Various surgical methods are available for treating tibial plateau fractures, including open, fluoroscopic-assisted, and arthroscopic approaches. Promptly addressing depressed articular surfaces is crucial to prevent rapid arthrosis progression. Arthroscopic-assisted procedures offer benefits like direct visualization of reduction, treatment of intra-articular issues, and faster patient recovery. Recent advancements in arthroscopic techniques enable precise reduction without fluoroscopy, reducing soft tissue damage and the risk of complications such as infection and cartilage damage.
Arthroscopic-assisted surgery offers precise treatment for Schatzker type II tibial plateau fractures, representing a promising future direction in surgery.
成人骨折中有1%为胫骨平台骨折，但对患者而言可能导致严重的发病情况。实现关节面的解剖复位、足够的对线、与早期活动相一致的稳定固定以及最小化软组织损伤是治疗的关键目标。与切开复位内固定相比，关节镜辅助下经皮固定的侵入性降低，从而降低了发病率。
一名35岁女性骑摩托车失控，左膝着地。左膝立即疼痛，无法行走或活动膝关节。最初的X线片显示胫骨外侧平台骨折伴塌陷，计算机断层扫描（CT）显示胫骨后外侧平台骨折伴塌陷，关节间隙不匹配。将该损伤分类为Schatzker 2型胫骨平台骨折，她接受了关节镜辅助下胫骨外侧平台切开复位内固定术。
治疗胫骨平台骨折有多种手术方法，包括切开、透视辅助和关节镜手术。及时处理塌陷的关节面对于防止快速的关节炎进展至关重要。关节镜辅助手术具有如直接观察复位情况、治疗关节内问题以及患者恢复更快等优点。关节镜技术的最新进展使得无需透视即可精确复位，减少了软组织损伤以及感染和软骨损伤等并发症的风险。
关节镜辅助手术为Schatzker II型胫骨平台骨折提供了精确的治疗方法，代表了手术领域一个有前景的未来方向。
