Skip to main content
Log in

The role of arthroscopy in articular fracture management: the lower limb

  • General Review • ANKLE - TRAUMA
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

The management of articular fracture is always a matter of concern. While each articular fracture is different from one another, besides the classification system used and the surgical or non-surgical indication given by the specialist, main goals remain the same: anatomical reduction, stable fixation, loose body removal, and minimal invasiveness. Open procedures are the actual compromise, but unfortunately, it is not always possible to perfectly meet every treatment goal, associated lesions could pass unnoticed or delayed in treatment, and even in a best-case scenario, there could be several complications developing in the long term. In the last decades, arthroscopic joint surgery underwent an exponential evolution, expanding its application also in the trauma field with the development of arthroscopic and arthroscopically assisted reduction and internal fixation (ARIF) techniques; main advantages are an accurate diagnosis of fracture and associated soft tissue involvement, the potential for concomitant treatments, anatomical reduction, and minimal invasiveness. ARIF techniques have been applied to treat fractures affecting several joints: shoulder, elbow, wrist, hip, knee, and ankle. The purpose of this paper was to provide a review of the most recent literature about arthroscopic and arthroscopically assisted reduction and internal fixation for articular and periarticular fractures of the lower limb, analyzing the results and suggesting clinical applications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Reference

  1. Teeny SM, Wiss DA (1993) Open reduction and internal fixation of tibial plafond fractures. Variables contributing to poor results and complications. Clin Orthop 292:108–1174

    PubMed  Google Scholar 

  2. Walsh EF, Akelman E, Fleming BC, DaSilva MF (2005) Thumb carpometacarpal arthroscopy: a topographic, anatomic study of the thenar portal. J Hand Surg 30A:373–379

    Article  Google Scholar 

  3. Hildebrand KA, Ross DC, Patterson SD, Roth JH, MacDermid JC, King GJ (2000) Dorsal perilunate dislocations and fracture-dislocations:questionnaire, clinical, and radiographic evaluation. J Hand Surg Am 25:1069–1079

    Article  CAS  PubMed  Google Scholar 

  4. Budoff JE (2008) Treatment of acute lunate and perilunate dislocations. J Hand Surg Am 33:1424–1432

    Article  PubMed  Google Scholar 

  5. Atesok K, Doral MN, Whipple T et al (2011) Arthroscopy-assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc 19:320–329. doi:10.1007/s00167-010-1298-7

    Article  PubMed  Google Scholar 

  6. Kim H, Baek JH, Park SM, Ha YC (2014) Arthroscopic reduction and internal fixation of acetabular fractures. Knee Surg Sports Traumatol Arthrosc 22:867–870

    Article  PubMed  Google Scholar 

  7. Ilizaliturri VM Jr, Gonzalez-Gutierrez B, Gonzalez-Ugalde H, Camacho-Galindo J (2011) Hip arthroscopy after traumatic hip dislocation. Am J Sports Med 39(Suppl):50S–57S

    Article  PubMed  Google Scholar 

  8. Yamamoto Y, Ide T, Ono T, Hamada Y (2003) Usefulness of arthroscopic surgery in hip trauma cases. Arthroscopy 19:269–273

    Article  PubMed  Google Scholar 

  9. Park MS, Yoon SJ, Choi SM (2013) Hip arthroscopic management for femoral head fractures and posterior acetabular wall fractures (Pipkin type IV). Arthrosc Tech 2(3):e221–e225

    Article  PubMed Central  PubMed  Google Scholar 

  10. Matsuda DK (2009) A Rare Fracture, an Even Rarer Treatment: the Arthroscopic Reduction and Internal Fixation of an Isolated Femoral Head Fracture. Arthroscopy 24(4):408–412

    Article  Google Scholar 

  11. Demirel M, Dereboy F, Ozturk A, Turhan E (2006) Arthroscopically assisted intra-articular lateral femoral condyle fracture surgery. Arthroscopy 22:690.e1–690.e4

    Article  Google Scholar 

  12. Dines JS, Fealy S, Potter HG, Warren RF (2008) Outcomes of osteochondral lesions of the knee repaired with a bioabsorbable device. Arthroscopy 24:62–68

    Article  PubMed  Google Scholar 

  13. Taitsman LA, Frank JB, Mills WJ, Barei DP, Nork SE (2006) Osteochondral fracture of the distal lateral femoral condyle: a report of two cases. J Orthop Trauma 20:358–362

    Article  PubMed  Google Scholar 

  14. Gul R, Khan F, Maher Y, O’Farrell D (2006) Osteochondral fractures in the knee treated with butyl-2-cyanoacrylate glue: a case report. Acta Orthop Belg 72:641–643

    PubMed  Google Scholar 

  15. Wouters DB, Burgerhof JGM, de Hosson JTM, Bos RRM (2011) Fixation of osteochondral fragments in the human knee using Meniscus Arrows. Knee Surg Sports Traumatol Arthrosc 19:183–188. doi:10.1007/s00167-010-1158-5

    Article  PubMed Central  PubMed  Google Scholar 

  16. Gras F, Marintschev I, Koenig V, Wilharm A, Mueckley T, Hofmann GO (2011) Arthroscopic controlled reduction of femoral condyle fractures using a retrograde navigated approach. Arch Orthop Trauma Surg 131:393–397

    Article  PubMed  Google Scholar 

  17. Bowers AL, Huffman GR (2008) Suture bridge fixation of a femoral condyle traumatic osteochondral defect. Clin Orthop Relat Res 466:2276–2281

    Article  PubMed Central  PubMed  Google Scholar 

  18. Lai SY, Becker DG (2014) Sutures and needles. E-medicine. com http://www.emedicine.com/ent/topic38.htm. Last visited 09/09/2014

  19. McLennan JG (1982) The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. J Bone Joint Surg Br 164:477–480

    Google Scholar 

  20. Hunter RE, Willis JA (2004) Arthroscopic fixation of avulsion fractures of the tibial eminence: technique and outcome. Arthroscopy 20(2):113–121

    Article  PubMed  Google Scholar 

  21. Huang TW, Hsu KY, Cheng CY, Chen LH, Wang CJ, Chan YS, Chen WJ (2008) Arthroscopic suture fixation of tibial eminence avulsion fractures. Arthroscopy 24:1232–1238

    Article  PubMed  Google Scholar 

  22. Verdano MA, Pellegrini A, Lunini E, Tonino P, Ceccarelli F (2014) Arthroscopic absorbable suture fixation for tibial spine fractures. Arthrosc Tech 3(1):e45–e48

    Article  PubMed Central  PubMed  Google Scholar 

  23. BongMR Romero A, Kubiak E, Iesaka K, Heywood CS, Kummer F et al (2005) Suture versus screw fixation of displaced tibial eminence fractures: a biomechanical comparison. Arthroscopy 21(10):1172–1176

    Article  Google Scholar 

  24. Chan YS, Yuan LJ, Hung SS et al (2003) Arthroscopically-assisted reduction with bilateral buttress plate fixation of complex tibial plateau fractures. Arthroscopy 19:974–984

    Article  PubMed  Google Scholar 

  25. Burdin G (2013) Arthroscopic management of tibial plateau fractures: surgical technique. Orth Traumatol Surg Res 995:S208–S218

    Article  Google Scholar 

  26. Dall’Oca C, Maluta T, Lavini F, Bondi M, Micheloni GM, Bartolozzi P (2012) Tibial plateau fractures: compared outcomes between ARIF and ORIF. Strat Trauma Limb Reconstr 7:163–175

    Article  Google Scholar 

  27. Odhera T, Tokunaga M, Hiroshima S, Yoshimoto E, Tokunaga J, Kobayashi A (2003) Arthroscopic management of tibial plateau fractures-comparison with open reduction method. Arch Orthop Trauma Surg 123:489–493

    Article  Google Scholar 

  28. Fowble CD, Zimmer JW, Schepsis AA (1993) The role of arthroscopy in the assessment and treatment of tibial plateau fractures. Arthroscopy 9:584–590

    Article  CAS  PubMed  Google Scholar 

  29. Myer DM, Purnell GJ Jr, Caldwell PE III, Pearson SE (2013) ORV arthroscopic reduction and internal fixation of tibial eminence fractures. Arthrosc tech 2(4):e341–e345

    Article  PubMed Central  PubMed  Google Scholar 

  30. Wajsfisz A, Makridis KG, Van Den Steen JY, Djian P (2012) Fixation of posterior cruciate ligament avulsion fracture with the use of a suspensory fixation. Knee Surg Sports Traumatol Arthrosc 20:996–999

    Article  PubMed  Google Scholar 

  31. Sasaki SU, da Mota e Albuquerque RF, Amatuzzi M, Pereira CA (2007) Open screw fixation versus arthroscopic suture fixation of the tibial posterior cruciate ligament avulsion injuries: a mechanical comparison. Arthroscopy 23(11):1226–1230

    Article  PubMed  Google Scholar 

  32. Zhang H, Hong L, Wang XS, Zhang J, Liu X, Feng H (2011) All-arthroscopic repair of arcuate avulsion fracture with suture anchor. Arthroscopy 27(5):728–734

    Article  CAS  PubMed  Google Scholar 

  33. El-Sayed AMM, Ragab RK (2009) Arthroscopic-assisted reduction and stabilization of transverse fracture of the patella. Knee 26:54–57

    Article  Google Scholar 

  34. Dhawan A, Hospodar PP (1999) Suture fixation as a treatment for acute traumatic osteochondral lesions. Arthroscopy 15:307–311

    Article  CAS  PubMed  Google Scholar 

  35. Bonar S, Marsh J (1994) Tibial plafond fractures: changing principles of treatment. J Am Acad Orthop Surg 2(6):297–305

    PubMed  Google Scholar 

  36. Ruch DS, Vallee J, Poehling GG, Smith BP, Kuzma GR (2004) Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures. Arthrosc J Arthrosc Relat Surg 20:225–230. doi:10.1016/j.arthro.2004.01.010

    Article  Google Scholar 

  37. Lonjon G, Delgrande D, Solignac N, Faivre B, Hardy P, Bauer T (2014) Arthroscopic treatment in split depression-type tibial pilon fracture. Eur J Orthop Surg Traumatol. doi:10.1007/s00590-014-1492-2

    PubMed  Google Scholar 

  38. Kralinger F, Lutz M, Wambacher M, Smekal V, Golser K (2003) Arthroscopically assisted reconstruction and percutaneous screw fixation of a Pilon tibial fracture. Arthroscopy 19(5):E45

    Article  PubMed  Google Scholar 

  39. Hammond AW, Crist BD (2012) Arthroscopic management of C3 tibial plafond fractures: a technical guide. J Foot Ankle Surg 51:382–386

    Article  PubMed  Google Scholar 

  40. Poyanli O, Esenkaya I, Ozkrut AT, Akcal MA, Akan K, Unay K (2012) Minimally invasive reduction technique in split depression type tibial pilon fractures. J Foot Ankle Surg 51:254–257

    Article  PubMed  Google Scholar 

  41. Thaunat M, Billot N, Bauer T, Hardy P (2007) Arthroscopic treatment of a juvenile tillaux fracture. Knee Surg Sports Traumatol Arthrosc 15:286–288

    Article  PubMed  Google Scholar 

  42. Turhan E, Doral MN, Demirel M et al (2013) Arthroscopy-assisted reduction versus open reduction in the fixation of the medial malleolar fractures. Eur J Orthop Surg Traumatol 23:953–959

    Article  PubMed  Google Scholar 

  43. Leontaritis N, Hinojosa N, Panchbhavi VK (2009) Arthroscopically detected intra-articular lesions associated with acute ankle fractures. J Bone Joint Surg Am 91:333–339

    Article  PubMed  Google Scholar 

  44. Thordarson DB, Bains R, Sheperd LE (2001) The role of ankle arthroscopy on the surgical management of ankle fractures. Foot Ankle Int 22:123–125

    CAS  PubMed  Google Scholar 

  45. Gavlik JM, Rammelt S, Zwipp H (2002) Percutaneous, arthroscopically- assisted osteosynthesis of calcaneus fractures. Arch Orthop Trauma Surg 122:424–428

    PubMed  Google Scholar 

  46. Gill TJ, Moezzi DM, Oates KM, Sterett WI (2001) Arthroscopic reduction and internal fixation of tibial plateau fractures in skiing. Clin Orthop 383:243–249

    Article  PubMed  Google Scholar 

  47. Howells NR, Gill HS, Carr AJ, Price AJ, Rees JL (2008) Transferring simulated arthroscopic skills to the operating theatre: a randomised blinded study. J Bone Joint Surg Br 90:494–499

    Article  CAS  PubMed  Google Scholar 

  48. Matsuda DK (2009) A rare fracture, an even rarer treatment: the arthroscopic reduction and internal fixation of an isolated femoral head fracture. Arthroscopy 25:408–412

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Luca Dei Giudici.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dei Giudici, L., Di Muzio, F., Bottegoni, C. et al. The role of arthroscopy in articular fracture management: the lower limb. Eur J Orthop Surg Traumatol 25, 807–813 (2015). https://doi.org/10.1007/s00590-015-1601-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-015-1601-x

Keywords

Navigation