Twenty-two skiers suffered fractures of the tibial plateau and eminence of the tibia from downhill skiing between 1993 and 1998. Sixteen cases of the 22 tibial plateau fractures were treated with an arthroscopic reduction and internal fixation of the articular surface without a formal arthrotomy or detachment of the anterior horn of the lateral meniscus. The average age of the patients at the time of surgery was 40 years (ranging from 24 to 55 years). Fourteen patients were male and eight patients were female. Twelve of these plateau fractures were classified according to Schayzker [15]. The distribution was as follows: one case Type I; three cases Type II; four cases Type III; two cases Type IV; zero case Type V; and two cases Type VI; ten cases of intercondylar eminence of the tibia were classified according to Meyers [13]; six cases of Type I; one case of Type II; three cases of Type III.

The Type II and III, according to Schayzker's fractures [15], required elevation of the depressed fragments from below through a bony window, bone grafting the resultant metaphyseal defect, and rigid internal fixation using an L-buttress plate. The principles for arthroscopic reduction and internal fixation of tibial plateau fractures are essentially the same as those of conventional open reduction and internal fixation. The split depression and joint depression fracture types were suited for arthroscopic reduction and internal fixation. The treatment goals are restoration of joint congruity, restoration of normal alignment, joint stabilization, and, ultimately, prevention of degenerative arthritis. There were no valgus malunions and no non-unions: radiographic findings of early degenerative changes were not seen in 14 of 22 patients at an average of twelve months follow-up (range from 6 months to 60 months).