Arthroscopic management of tibial plateau fractures.

Twenty-one tibial plateau fractures with 1 to 5 years follow-up are reviewed for the purpose of demonstrating the positive impact arthroscopy can have on patients sustaining this injury. Controversy between open and nonopen management has existed for decades. Arthroscopy bridges that controversy, allowing the advantages of accurate reduction and rigid fixation without extensive operative exposure. In addition, arthroscopy allows thorough lavage, removal of loose fragments, and accurate diagnosis of associated intraarticular pathology. Since extensive exposure is avoided, rapid recovery with reduced pain and early full range of motion is achieved in patients managed arthroscopically. Biomechanics of rigid percutaneous internal and external fixation are presented to demonstrate that no principles are compromised in arthroscopic management. Associated meniscal and ligamentous injuries in this series are treated either arthroscopically or through secondary accessory incisions. Fractures are classified as to the applicability of arthroscopic management.