[Arthroscopic evaluation of tibial plateau fractures combined with meniscal tears and cruciate ligamentous injuries].

Objectives: To investigate the types of meniscal tears and cruciate ligamentous injuries in patients with tibial plateau fracture(TPF) following arthroscopic examination. Methods: The clinical data of 216 patients with TPF who underwent closed reduction and internal fixation (CRIF) from January 2016 to January 2019 at Trauma Emergency center, the Third Hospital of Hebei Medical University were analyzed retrospectively. There were 147 males (147 knees) and 69 females (69 knees),aged 46.3 years (range: 18 to 80 years). All patients underwent closed reduction for the displaced fracture fragment with the use of bidirectional rapid redactor,and minimally invasive percutaneous plate osteosynthesis. Intra-operative arthroscopic examination was performed to exam the stability of meniscus and the continuity of cruciate ligamentous after CRIF. The percentages and types of meniscal tears and cruciate ligamentous injuries were recorded. Results: The overall percentages of meniscal tears associated with TPFs was 48.6%(105/216). The most common pattern of meniscal tears was longitudinal tears, accounting for 43.8% (46/105), and it occurred most frequently in Schatzker type Ⅱ (58.7%, 27/46). Furthermore, the percentage of meniscal complex tears was 17.1% (18/105), occurring most frequently in Schatzker type Ⅴ (9/18). The overall percentage of cruciate ligamentous injuries associated with TPFs was 17.1% (37/216), and the percentages of anterior cruciate ligament (ACL) injuries was 64.9%(24/37), the percentage of posterior cruciate ligament injuries was 35.1%(13/37). Avulsion fracture was the most common pattern in ACL injuries, accounting for 41.7% (13/24), and all occurred in the tibial insertion site. Conclusions: In the present study, the percentages of meniscal tears and ligamentous injuries in TPFs are 48.6% and 17.1%, respectively. The most common types are meniscal longitudinal tears and ACL injury, occurring most frequently in Schatzker type Ⅱ and Ⅳ, respectively. Recognition of concomitant meniscal tears and cruciate ligamentous injuries in TPFs is helpful for trauma physicians to choose the best surgical treatment.