Percutaneous fixation of tibial plateau fractures under arthroscopy: a medium term perspective.
Résumé
INTRODUCTION: Arthroscopically assisted percutaneous internal fixation has found its place in the treatment of Schatzker I-III tibial plateau fractures, with good short-term results reported. The objective of this study was to observe the progression of osteoarthritis at the medium term through clinical and radiological assessment. PATIENTS AND METHODS: Twenty-seven patients were treated with arthroscopy-assisted percutaneous fixation for stage I-III Schatzker tibial plateau fractures. RESULTS: Twenty-one patients were reviewed with a mean follow-up of 59.5 months (range, 24-138 months); satisfaction was good except for return to sports activity. The mean IKS score was 85.2 for the knee score and 91 for function. The mean Lysholm score was 86 points, with a mean Tegner activity score of 4. A mean score of 25.5 and 8 points was found for the clinical and radiological Rasmussen scores, respectively; 47.6% of the patients presented early osteoarthritis on radiological evaluation. DISCUSSION: The medium-term functional results were comparable to the short-term results. The patients were satisfied except for return to sports activity. Age at surgery appears as a prognostic factor for osteoarthritis. CONCLUSION: Arthroscopic internal fixation remains the technical reference for Schatzker I-III tibial plateau fractures despite the appearance of osteoarthritis, which remains less extensive than in open surgery. LEVEL OF EVIDENCE: Level IV. Retrospective study.