ObjectiveTo investigate the efficacy of arthroscopic-assisted reduction and internal fixation in the treatment of Schatzker type I and Ⅱ tibial plateau fractures. MethodsA total of 60 patients with Schatzker type I or Ⅱ tibial plateau fractures were selected as the observation objects and randomly divided into an endoscopic group and a control group by the coin tossing method, with 30 cases in each group. The endoscopic group was treated with arthroscopic-assisted reduction and internal fixation + bone grafting, and the control group was treated with open reduction and internal fixation + bone grafting. The perioperative indicators, follow-up results and imaging examination results were compared between the two groups. ResultsThe operation time, surgical incision length, intraoperative blood loss, fluoroscopy times, hospital stay, walking time and full weight-bearing activity time in the endoscopic group were all shorter/less than those in the control group, with statistically significant differences (all P＜0.05), but there were no statistically significant differences in incision healing and the excellent and good rate of fracture reduction between the two groups (all P＞0.05). Three months after surgery, the hospital for special surgery (HSS) score was higher and the range of motion (ROM) was larger in the endoscopic group as compared with those in the control group (all P＜0.05), but there was no statistically significant difference in the VAS score between the two groups (P＞0.05). Compared with those 3 months after surgery, the VAS score decreased, while the HSS score and ROM increased in both groups 1-year after surgery (all P＜0.05). However, there were no statistically significant differences in the VAS score, HSS score and ROM between the two groups 1-year after surgery (all P＞0.05). The medial proximal tibial angle (MPTA) 1-year after surgery in the endoscopic group was greater than that before surgery and that in the control group (P＜0.05). The fracture healing rate in the endoscopic group within 10 weeks was significantly higher than that in the control group (P＜0.05). The K-L classification of the two groups 1-year after surgery were better than that before surgery (P＜0.05), but there was no statistically significant difference between the two groups (P＞0.05). ConclusionArthroscopic reduction and internal fixation in the treatment of Schatzker type Ⅰ and Ⅱ tibial plateau fractures has definite curative effect, which can achieve fast fracture healing, early weight bearing, good joint function recovery and less cartilage degeneration, minimally invasive treatment of intra-articular injuries can be performed at the same time, with obvious advantages, and is worthy of popularization and application.

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