INTRA-OPERATIVE ASSESSMENT OF TIBIAL PLATEAU FRACTURE REDUCTION IN LOW-RESOURCE SETTINGS.

Abstract

Aim of the study: To summarize current intra-operative techniques for assessing tibial plateau fracture reduction, with a particular focus on their feasibility and applicability in low-resource settings.

Material and methods: This narrative review synthesizes literature describing intraoperative assessment strategies for tibial plateau fractures. Although no single study specifically addressed reduction assessment in low-resource environments, relevant articles discussing imaging-based assessments (e.g. fluoroscopy, 3D imaging), direct visualization approaches (e.g. arthrotomy), and tactile reduction techniques were included based on clinical relevance and applicability.

Results: Conventional 2D fluoroscopy remains the most widely used intraoperative imaging modality, despite its limited sensitivity for subtle articular incongruities. Direct visualization techniques, including arthrotomy, provide reliable tactile and visual assessment without requiring advanced imaging. Emerging innovations such as smartphone-assisted tools and 3D printing hold promise but currently lack validation in low-resource settings. There remains a notable gap in literature addressing tailored intraoperative assessment protocols for resource-constrained environments.

Conclusions: In the absence of advanced intraoperative imaging, reliance on fundamental principles-such as thorough preoperative planning, direct visual and tactile assessment, and structured surgical technique-remains essential. There is an urgent need for context-specific research and pragmatic innovations to improve intraoperative fracture assessment and surgical outcomes in low-resource settings.