Fragment Specific Fixation for Tibial Plateau Fractures with particular reference to arthroscopic assisted surgery.

Background: Tibial plateau fractures treatment strategies have shifted away from relying only on the Schatzker or AO/OTA categorization, as the idea of the proximal tibia as a three-column structure. This is a prospective randomized study for evaluation of the results of management of tibial plateau fractures especially posterior column with reference to arthroscopic assisted surgery according to fragment specific fixation concept based on Luo three column classification (CT based). Methods: This is a prospective randomized study for evaluation of the results of management of tibial plateau fractures especially posterior column with reference to arthroscopic assisted surgery according to fragment specific fixation concept based on Luo three column classification (CT based). This study was conducted on (thirty) patients with tibial plateau fractures, 20 cases was treated by ORIF & 10 cases treated by ARIF. They were treated in Minia University hospital & El-Minia General Hospital during the period from June 2018 to May 2021. All patients were followed up for at least one year. Results and conclusion: We concluded that fragment specific fixation for tibial plateau fractures under guiding of three column classification showing excellent results for tabial plateau fracture mainly posterior column injuries using Lysholm scores for clinical evaluation and Rasmussen score for radiological evaluation. Moreover, arthroscopically assisted internal fixation (ARIF) had higher Lysholm score and Rasmussen scores when compared to others performed traditional ORIF.In this study we used ARIF method in posterolateral column with or without lateral column fractures as recommended in literature [4]. Randomization was done in cases with posterolateral column fracture to be treated by ORIF or by ARIF by card selection.They were treated in Minia University hospital & El-Minia General Hospital during the period from June 2018 to May 2021. All patients were followed up for at least one year.We concluded that fragment specific fixation for tibial plateau fractures under guiding of three column classification showing excellent results for tabial plateau fracture mainly posterior column injuries using Lysholm scores for clinical evaluation and Rasmussen score for radiological evaluation. Moreover, arthroscopically assisted internal fixation (ARIF) had higher Lysholm score and Rasmussen scores when compared to others performed traditional ORIF.