Minimally invasive plate osteosynthesis versus ORIF in treatment of intra-articular fracture of knee joint / 中国矫形外科杂志

ABSTRACT

[Objective]To comparatively analyze the clinical results of minimally invasive plate osteosynthesis (MIPO) and ORIF in treatment of intra-articular fracture of knee joint and to investigate the utilization value of biological fixation.[Method]According to the principles of conservation of the vascularity,21 cases of intra-articular fractures of knee joint underwent surgical treatment of MIPO in recent years.In accordance with the type of fracture and other anticipated factors influenced bony healing,paired-samples treated of ORIF were selected.The two groups were compared following operation time,intra-operative blood loss,bone union time,axial malalignment radiologically of knee joint,and the ROM of knee.HSS criteria were used to evaluate the results.[Result]In MIPO group,all 21 fractures were followed up for averagely 14.2 months (range 10~16 months).The mean duration of surgery was 60.0 min (range 50~70 min) and bone grafting underwent in 2 cases.Complete fracture healing was achieved with the average time of 10.0 weeks and assessment of vallgus/varus alignment showed a deviation more than 5 degrees in 3 cases.The average HSS score was 86.67.In ORIF group,all 21 fractures were followed up for averagely 21.2months (range 12~48 months).The mean duration of surgery was 79.52 min (range 65-95 min) and bone grafting underwent in 18 cases.Complete fracture healing was achieved with the average time of 12.24 weeks and assessment of valgus/varus alignment showed a deviation more than 5 degrees in 2 cases.The average HSS score was 82.14.All patients got bony union and no patient developed infection,implant failure in both groups.There was significant difference in operation time,union time and function of knee between the two groups.[Conclusion]To the suitable cases,MIPO appears to stabilize fractures with a low intra-operative blood loss and a low incidence of bone grafting; on the other hand it offers many advantages in the aspects of operation procedures and functional recovery postoperatively.