THE SURGICAL TREATMENT OF TIBIAL PLATEAU FRACTURES: ARTHROSCOPY VERSUS ARTHROTOMY
Abstract:
The purpose of the clinical study is to determine the advantages and disadvantages of the arthroscopic control of reduction, associated with the minimally invasive osteosynthesis in tibial plateau fractures and to compare it with classical osteosynthesis. It was a prospective, randomized study on a group of 45 patients with tibial plateau fractures: group I – in 22 cases, the reduction was made exclusively under arthroscopic control, with the insertion of an elevator through a minimal incision. Ostheosynthesis was also performed with screws and washers through minimal incisions and group II – in 23 cases, the approach was the classical one +/- arthrotomy. The reduction was made under visual and radiological control (sometimes, the visualization of the joint surface of the plateau was necessary through arthrotomy +/- meniscectomy due to meniscus injuries or tactic meniscectomy for the visualization of that particular zone), while ostheosynthesis was made with the plate and screws and/or screws. The two groups were similar regarding age, sex ratio, BMI, type of fracture, degree of comminution of the fracture, type of professional and sports activity of the patients in the pre-traumatic period. The following parameters were taken into consideration: Lysholm score, mobility, pain, the need for a surgical intervention, the occurence of degeneratice lesions.
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