Modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures

doi:10.3969/j.issn.2095-4344.2832

Abstract

Abstract:

BACKGROUND: Studies have shown that the adjuvant use of long bone distraction device for unstable tibial plateau fractures achieved satisfactory results, but the safety of its use of long bone distraction device is not high, and the device could easily lead to soft tissue damage.

OBJECTIVE: To compare the clinical efficacy of modified knee joint spreader combined with minimally invasive percutaneous plate internal fixation and traditional incision reduction plate internal fixation for the treatment of complex tibial plateau fractures.

METHODS: A total of 71 patients with complicated tibial plateau fractures admitted to Xiangdong Hospital Affiliated to Hunan Normal University from January 2016 to January 2018 were included, including 48 males and 23 females. The 34 patients in the experimental group received modified knee spreaders combined with minimally invasive percutaneous plate internal fixation treatment. The 37 patients in the control group received traditional open reduction and plate internal fixation. The incision length, operation time, intraoperative blood loss, hospital stay, the time of fracture healing and the incidence of postoperative complications were compared between the two groups. Knee HSS scores were assessed at 1 month and at the last follow-up. The trial was approved by the Ethics Committee of Xiangdong Hospital Affiliated to Hunan Normal University.

RESULTS AND CONCLUSION: (1) The operation time, intraoperative blood loss, incision length, and hospital stay were shorter in the experimental group than in the control group (P < 0.05). There was no significant difference in fracture healing time between the two groups (P > 0.05). (2) One case of joint stiffness and one case of traumatic arthritis were found in the experimental group. One case of postoperative infection, five cases of joint stiffness, one case of traumatic arthritis and one case of loosening of the internal fixation were found in the control group. The incidence of complications in the experimental group was less than that in the control group (P < 0.05). (3) Seventy-one patients were followed up for 10-14 months. The knee function HSS score of the experimental group at 1 month after operation was significantly better than that of the control group (P < 0.05). There was no significant difference in the HSS scores during the final follow-up between both groups (P > 0.05). (4) The results showed that compared with the traditional open reduction and internal fixation, the modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures can improve the operation efficiency, reduce surgical trauma, reduce the incidence of postoperative complications, and shorten hospital stay for patients.

Key words: complex tibial plateau fracture, modified spreader, minimally invasive percutaneous plate internal fixation, MIPPO technology, surgical treatment, internal fixation, knee function, complications

CLC Number:

Wu Cai, Luo Tian, Zeng Qinghu, Peng Chengzhong, Liao Tao, Wang Lele, Zeng Zhao. Modified knee spreader combined with minimally invasive percutaneous plate internal fixation for complex tibial plateau fractures[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(27): 4305-4309.

Figures/Tables 10

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