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Abstract

The primary objective of fracture fixation is to obtain anatomic reduction with stable fixation while minimizing damage to the surrounding structures. Displaced articular fractures represent a surgical challenge, but anatomic alignment with restoration of the articular surface is the gold standard of management. Using open techniques, intra-articular visualization can require large dissections and added soft-tissue insult. However, arthroscopic-assisted open reduction internal fixation (AAORIF) may represent a less invasive means of articular fracture management in appropriate patients with select fractures. The general principles of AAORIF are modified from basic arthroscopic principles, including positioning, portal placement, fluid management, visualization, soft-tissue management, and fracture preparation. An arthroscopic approach provides additional exposure while minimizing soft-tissue dissection and offers alternative routes of reduction and instrumentation. Benefits of AAORIF include limited soft-tissue dissection to visualize the articular surface and the ability to address concomitant pathology. This article highlights key tips and tricks for successful use of AAORIF for displaced articular fractures.

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