Comparison of traditional open reduction and internal fixation versus minimally invasive reduction by a rapid reductor and percutaneous plate fixation for tibial plateau fractures / 中华创伤骨科杂志

ABSTRACT

Objective To compare traditional open reduction and internal fixation versus minimally invasive reduction by a rapid redactor and percutaneous plate fixation for tibial plateau fractures.Methods From October 2015 to January 2017,we treated 40 patients with tibial plateau fracture.They were 27 males and 13 females,aged from 17 to 73 years.There were 15 cases of type [[,2 of type Ⅲ,6 of type Ⅳ,10 of type Ⅴ and 7 of type Ⅵ according to the Schatzker classification.Of them,20 were treated by traditional open reduction and internal fixation and the other 20 by minimally invasive reduction by a rapid redactor and percutaneous plate fixation.The 2 groups were compared in terms of operating time,intraoperative blood loss,incision complications,and Hospital for Special Surgery (HSS) score of the knee joint at final follow-ups.Results The 2 groups were compatible because there were no significant differences in all the preoperative demographic data but the interval from injury to surgery (P ＞ 0.05).The 40 patients were followed up for an average of 9.3 months(from 3.5 to 14.5 months).There were significant differences in operating time (103.2 ±35.1 minversus 110.9 ±42.3 min),intraoperative blood loss (157.5 ± 90.7 mL versus 235.0 ± 137.6 mL),active mobility time after operation (9.5 ± 4.0 d versus 12.2 ± 5.6 d),bony union time (14.5 ± 2.7 w versus 15.4 ± 2.9 w),hospital stay (12.1 ± 3.1 d versus 14.6 ± 3.4 d),knee flexion range (125.4° ± 28.3° versus 115.3° ± 21.5°),knee extention range (12.7°±1.4° versus 9.7°±1.5°) and HSS knee score (87.8±7.0 versus 83.1±8.5) (P ＜0.05),favoring the group of minimally invasive reduction.There was no significant difference between the 2 groups in the rate of complications[15％ (3/20) versus 10％ (2/20)] (P ＞ 0.05).Conclusions Compared with traditional open reduction and internal fixation,minimally invasive reduction by a rapid reductor and percutaneous plate fixation is a better option for tibial plateau fractures,due to its advantages of decreased operating time and hospital stay,less trauma and hemorrhage,fewer complications and more rapid functional recovery of the knee.