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Arthrography-assisted reduction in minimally invasive treatment of tibial plateau fractures / 中华创伤骨科杂志
Chinese Journal of Orthopaedic Trauma ; (12): 126-131, 2021.
Article in Chinese | WPRIM | ID: wpr-884230
ABSTRACT

Objective:

To evaluate arthrography-assisted reduction in minimally invasive treatment of tibial plateau fractures.

Methods:

From January to May 2019, 9 patients with tibial plateau fracture were treated by arthrography-assisted minimally invasive surgery at Department of Orthopaedics and Traumatology, Hong-Hui Hospital. They were 6 males and 3 females with an average age of 45.5 years (from 27 to 63 years). According to the Schatzker classification, there were 6 cases of type Ⅱ, one of type Ⅲ and 2 cases of type Ⅳ. Arthrography was used to determine the lowest filling point of contrast medium after intra-articular injection and to ensure satisfactory reduction of articular surface after fracture reduction and bone grafting, followed by minimally invasive percutaneous plate implantation. Comparisons were made between preoperation and 6 months postoperation in the range of knee motion and knee scores of The Hospital for Special Surgery (HSS). Knee X-ray films were evaluated by the Rasmussen imaging system at 6 months postoperation. Collapse of articular surface was recorded pre- and post-operation as well as postoperative complications.

Results:

All the 9 patients were followed up for 6 to 9 months (average, 7 months). All patients achieved bony union within 12 weeks postoperation. The preoperative knee flexion (60.7°±13.1°) and HSS (51.9±5.7) were significantly improved to 122.4°±10.8° and 84.9±5.3 at 6 months postoperation ( P<0.05), but there was no significant difference between preoperation and 6 months postoperation in knee extension (4.4°±2.5° versus 4.6°±2.9°) ( P>0.05). The collapse of articular surface was improved from preoperative 9.5 mm (from 5 to 15 mm) to postoperative 1.3 mm (from 0 to 3 mm). The Rasmussen imaging scores at 6 months postoperation showed 6 excellent and 3 good. No such postoperative complications occurred as incision infection, joint stiffness, loosening or breakage of implants.

Conclusion:

Arthrography helps minimally invasive treatment of tibial plateau fracture because it can better display fracture collapse during operation and accurately judge indirect reduction of articular surface.
Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Orthopaedic Trauma Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Orthopaedic Trauma Year: 2021 Type: Article