Dataset Information

Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures by Viewing and Instrumentation Access Through Coexisting Meniscus Tear: Case Series.

ABSTRACT: Meniscus tear coexisting with tibial plateau fractures may be found in 2-49% of cases. Literature accepts that torn meniscus can be retracted towards the center to improve visualization of the peripheral plateau which is ordinarily concealed by the overlying meniscus. We hypothesized that easing in microscope through a coexisting tear may be much less disruptive with little or no adverse effects with respect to either the propagation of tear or its later repair. This strategy improved visualization as well as the extended reach of interventional instrumentation access to otherwise concealed areas of plateau and endoscopic trans-focal access to a vertical limb of fracture split on the anterior cortex of proximal tibia without any impact on the stability of repaired meniscus. The experience in a series of six cases is shared.

Supplementary information

The online version contains supplementary material available at 10.1007/s43465-022-00703-7.

SUBMITTER: Manocha RK

PROVIDER: S-EPMC9385933 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures by Viewing and Instrumentation Access Through Coexisting Meniscus Tear: Case Series.

Manocha R K RK Vaish Atul A

Indian journal of orthopaedics 20220727 9

Meniscus tear coexisting with tibial plateau fractures may be found in 2-49% of cases. Literature accepts that torn meniscus can be retracted towards the center to improve visualization of the peripheral plateau which is ordinarily concealed by the overlying meniscus. We hypothesized that easing in microscope through a coexisting tear may be much less disruptive with little or no adverse effects with respect to either the propagation of tear or its later repair. This strategy improved visualizat ...[more]

PMID: 36052396

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Project description:PurposeTo determine trends in arthroscopic-assisted tibial plateau fracture fixation (AATPFF), to evaluate trends in the overall rate of tibial plateau fracture fixation, and to compare postoperative complications between AATPFF and traditional tibial plateau fixation.MethodsA retrospective review of patients undergoing AATPFF and traditional tibial plateau fixation was conducted using the Humana Inc. administrative database from 2007 to 2016. A 1:1 propensity match was utilized to match patients in the 2 study groups based on age, sex, obesity, diabetes, hypertension, chronic obstructive pulmonary disease, depression or anxiety, and smoking history. Postoperative complications were grouped as minor medical complications, major medical complications, surgical complications, emergency department visits, and reoperation. Linear regression analysis was used to assess trends and Pearson's χ2 test was used to compare postoperative complications with statistical significance defined as P < .05.ResultsIn total, 522 patients underwent AATPFF and 3920 patients underwent traditional tibial plateau fracture fixation. There was a 4-fold increase in the use of AATPFF over the study period (P = .0173). Similarly, there was an increase in the utilization of traditional tibial plateau fracture fixation, although to a lesser extent (1.33-fold). After propensity matching, the traditional fixation group demonstrated significantly higher rates of minor medical complications (8.2% vs 2.7%, P = .0002), major medical complications (9.9% vs 4.6%, P = .0018), surgical complications (13.2% vs 2.7%, P < .0001), and emergency department visits (21.4% vs 13.5%, P < .0001) within 90 days of surgery compared with the AATPFF group. There was no difference in reoperation rates within 90 days between the 2 groups (2.9% vs 3.6%, P = .85).ConclusionsThe incidence of tibial plateau fracture fixation is increasing, however, use of AATPFF is increasing at a faster rate compared to traditional techniques. Furthermore, the addition of knee arthroscopy to fracture fixation does not increase the risk of complication, reoperation, or emergency department visit within 90 days.Level of evidenceIII, retrospective matched cohort.

Dataset Information

Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures by Viewing and Instrumentation Access Through Coexisting Meniscus Tear: Case Series.

Supplementary information

Publications

Arthroscopic Assisted Reduction and Internal Fixation of Tibial Plateau Fractures by Viewing and Instrumentation Access Through Coexisting Meniscus Tear: Case Series.

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