Abstract number (40937) ADVANTAGES OF ARTROSCOPY IN

THE TREATMENT OF INTAARTICULAR FRACTURES OF

THE KNEE

N. Erhan, V. Vetrilă, V. Tocarciuc, A. Belous

R. Moldova, Chisinau, Medical University ,,Nicolae Testemiţanu”, Departament of Orthopedics and Traumatology

The objectives of surgical treatment in knee’s intaarticular fractures are:- perfect anatomical reduction- stabile osteosynthesis of fragments- resolving associated intraarticular injuries- minimization the risk of movement limitation- early mobilization.

Traditional surgery has a high rate of complications and a long time of recuperation. Arthroscopy creates an enormous progress in knee surgery. As in other cases of miniinvasive surgery, arthroscopic surgery allows diagnosis of all traumas, rigurous visual reduction control, with very good functional result and early recuperation..

Treatment Options : - Artoscopic - Traditional Open Reduction Internal Fixation (ORIF)

Questions :The possibility of tehnic artroscopycal reduction of the fracture? Will the osteosynthesis with screws, the only method of fixation atroscopycaly possible, be enaugh stable?Indications?Advantages and disadvantages?Priorities for the patient and the surgeon?Short and long term functional resoults?

The research includes arthroscopic treatment of 72 patients with intraarticular fractures of the knee, using arthroscopy and transcutaneus osteosynthesis with canulated screw in tibial, femoral and condilar fractures, type B1-B3 AO classification.• 72 patients of them were with condilo-tibial fractures• 8 – with femoral fractures• 22 cases of intercondilien eminence osteosynthesis were

done using style suture - 19 patients of them were with menyscal terse - 6 – with injure LCA - 1 – with injure LCP. In 8 cases of menyscal terse sutures were done, in 4 cases resection of the injured part, in 2 cases - proximal fixation of LCA.

Tools and Methods

Indications for osteosynthesis of intraarticular fractures of the knee under

arthroscopy are:

• Tibial plateau fractures type B. AO • Fractures of intercondilien eminence • Fractures of femur’s unicondilien type B, AO • Fractures of platella (selected cases)

Presented results were done after 2-4 years of follow-up surgery. The average of functional results were - 92,6; knee scores were – 89,5 (International Knee Score). After surgery the patients were without immobilization, with permission to make moves in knee articulation on the third day after surgery, excluding effort for 8-10 weeks.

Clinical Case: Fracture type B 3 AO

4 years follow-up:

Clinical Case: Patient M. 35 years old, with fracture of the tibial eminence, type 3 (Meyers M. H., McKeever F.(1970)) 3 days after trauma surgical treatment

involved the reduction of the fragments using arthroscopic technique and osteosynthesis with a screw.

After a year the radiologic and functional resoult was: IKSS – 95 points: extension/flexion - 0/0/130 grade.

Conclusion:Arthroscopic surgery is indicated in case of knee intraarticular fracture’s of type B, AO classification.

Arthroscopic surgery allows for early recovery of the articulation’s function. Long term, this improves results.

Arthroscopic surgery does not only reduce the perioperative morbidity, especially infections, but also allows the diagnosis and treatment of intraarticular associated injures without arthrotomy.