Arthroscopically assisted internal fixation of fractures of the distal tibia

Intra-articular fractures of the distal tibia are severe injuries of the ankle joint. Fracture management aims at optimal reconstruction of joint surfaces, restoration of correct alignment and length and a stable fracture fixation to allow an early functional rehabilitation protocol. Additional extra-articular fracture components, bone loss, extensive soft tissue deterioration and direct damage of the articular cartilage are frequently observed and lead to inferior results in some cases. Minimally invasive procedures minimize the complication rate and avoid any secondary compromise of soft tissue. The present study reviews the indications and operative techniques of arthroscopically and fluoroscopically assisted internal fixation, reviews the pertinent literature, discusses the pros and cons of individual surgical approaches and presents our own experiences. © 2010 Springer-Verlag.