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Arthroscopy. ) screw technique for arthroscopic reduction and internal fixation of compression fractures of the tibial plateau. Arthroscopy. ) (Fig. 3-4). The underlying metaphyseal bone and cortical disk serve as autograft. A calcium- or hydroxyapatite-impregnated bioabsorbable cannulated interference screw of large diameter is then advanced through the cortical window to elevate the fracture further under direct arthroscopic visualization (Fig. 3-5). The screw first provides elevation. 12 More- over, for type III patterns, the screw obviates the need for percutaneous placement of subchondral, metal, cannulated buttress screws, which radically reduces morbidity.

B, C, Plain radiographs showed solid bone union with normal alignment (anteroposterior and lateral views). The knee joint was very stable. D, After more than 7 years’ follow-up, no joint surface depression or post-traumatic osteoarthritis. Satisfaction with treatment (arthroscopy-assisted reduction with bilateral buttress plate fixation) was high. (From Chan Y, Chiu, C, Lo Y, et al. Arthroscopy-assisted surgery for tibial plateau fractures: 2- to 10-year follow-up results. Arthroscopy. 2008;24:760-768.

2,4-7 Closed reduction may be attempted for large type IIIB fractures because associated condylar contact may allow bony reduction after aspiration and hyperextension. 2 An impressively large series by Chan and coworkers3 is summarized in Table 3-1. The key point is that fracture types I, II, III, and IV had 100% satisfactory results. 5% satisfactory results and Schatzker type VI had 90% satisfactory results. Hunter and Willis8 have described the outcome of suture or screw fixation of Myers and McKeever types II and III tibial intercondylar eminence fractures.

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AANA Advanced Arthroscopy. The Knee by Robert E. Hunter

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