Tibial Plateau Fractures
Comparison of arthroscopy-assisted reduction and internal fixation versus open reduction and internal fixation for tibial plateau fractures
Xu Yan, Duan Deyu, Liu Guohui, Wang Junwen, He Lei, Ouyang Liu
Published 2021-02-15
Cite as Chin J Orthop Trauma, 2021, 23(2): 116-120. DOI: 10.3760/cma.j.cn115530-20200901-00569
Abstract
ObjectiveTo compare the efficacy between arthroscopy-assisted reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) in the treatment of tibial plateau fractures.
MethodsA retrospective analysis was done of the 75 patients with tibial plateau fracture who had been treated by ARIF or ORIF at Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage from January 2016 to August 2018. They were 58 men and 17 women, aged from 20 to 54 years (average, 47 years). The left side was affected in 42 cases and the right side in 33. By the Schatzker classification, there were 23 cases of type Ⅰ, 49 cases of type Ⅱ and 3 cases of type Ⅲ. Of them, 40 were treated by ARIF and 35 by ORIF. The 2 groups were compared in terms of operation time, incision length, intraoperative blood loss, hospital stay, postoperative complications and the Hospital for Special Surgery (HSS) scores 12 months after operation.
ResultsThere was no statistically significant difference between the 2 groups in the preoperative general data, showing the 2 groups were comparable (P>0.05). The patients were followed up for 12 to 15 months (average, 13.5 months) after operation. The wounds in the 75 patients healed at one stage with no complications like neurovascular lesions. All the fractures healed within 6 months after operation. Compared with the ORIF group, the ARIF group had significantly longer operation time (58.3 min ± 4.2 min versus 48.4 min ± 5.2 min), a significantly shorter incision (4.3 cm ± 0.9 cm versus 6.2 cm ± 0.8 cm), and significantly less intraoperative blood loss (60.8 mL ± 4.5 mL versus 72.8 mL ± 6.5 mL) (P<0.05). There was no significant difference between the 2 groups in hospital stay (5.1 d ± 0.6 d versus 5.5 d ± 1.6 d) (P>0.05). Fifteen patients in the ARIF group and 5 in the ORIF group were complicated with soft tissue injury, showing a statistically significant difference (P<0.05). The excellent and good rate by HSS scores was 100% (40/40) for the ARIF group and 85% (34/40) for the ORIF group, showing no significant difference (P>0.05).
ConclusionsIn the treatment of tibial plateau fractures of Schatzker types Ⅰ-Ⅲ, both ARIF and ORIF may result in good efficacy. However, ARIF can evaluate and treat the complicated soft tissue injuries to the knee joint more precisely, showing advantages of shorter operation time, a smaller incision and less blood loss.
Key words:
Knee joint; Arthroscopy; Fracture fixation, internal; Surgical procedures, minimally invasive; Tibial plateau fracture
Contributor Information
Xu Yan
Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, China
Duan Deyu
Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, China
Liu Guohui
Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, China
Wang Junwen
Department of Orthopaedics, Puai Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430033, China
He Lei
Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, China
Ouyang Liu
Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan 430022, China
