Arthroscopic evaluation of soft tissue injuries in tibial plateau fractures: retrospective analysis of 98 cases.
OBJECTIVE
This investigation arthroscopically assesses the frequency of soft tissue injury in tibial plateau fracture according to the severity of fracture patterns. We hypothesized that use of arthroscopy to evaluate soft tissue injury in tibial plateau fractures would reveal a greater number of associated injuries than have previously been reported.


METHODS
From March 1996 to December 2003, 98 patients with closed tibial plateau fractures were treated with arthroscopically assisted reduction and osteosynthesis, with precise diagnosis and management of associated soft tissue injuries. Arthroscopic findings for associated soft tissue injuries were recorded, and the relationship between fracture type and soft tissue injury was then analyzed.


RESULTS
The frequency of associated soft tissue injury in this series was 71% (70 of 98). The menisci were injured in 57% of subjects (56 in 98), the anterior cruciate ligament (ACL) in 25% (24 of 98), the posterior cruciate ligament (PCL) in 5% (5 of 98), the lateral collateral ligament (LCL) in 3% (3 of 98), the medial collateral ligament (MCL) in 3% (3 of 98), and the peroneal nerve in 1% (1 of 98); none of the 98 patients exhibited injury to the arteries. No significant association was noted between fracture type and incidence of meniscus, PCL, LCL, MCL, artery, and nerve injury. However, significantly higher injury rates for the ACL were observed in type IV and VI fractures.


CONCLUSIONS
Soft tissue injury was associated with all types of tibial plateau fracture. Menisci (peripheral tear) and ACL (bony avulsion) were the most commonly injured sites. A variety of soft tissue injuries are common with tibial plateau fracture; these can be diagnosed with the use of an arthroscope.


METHODS
Level III, diagnostic study.
Abdel-Hamid
Mohamed Zaki
MZ
Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. chan512@adm.cgmh.org.tw
Chang
Chung-Hsun
CH
Chan
Yi-Sheng
YS
Lo
Yang-Pin
YP
Huang
Jau-Wen
JW
Hsu
Kuo-Yao
KY
Wang
Ching-Jen
CJ
D000328:Adult; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005260:Female; D006801:Humans; D015994:Incidence; D022125:Lacerations / Q000453:epidemiology; D008023:Ligaments, Articular / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010543:Peroneal Nerve / Q000293:injuries; D012189:Retrospective Studies; D017695:Soft Tissue Injuries / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D013978:Tibial Fractures / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000070600:Tibial Meniscus Injuries; D015599:Trauma Severity Indices