Clinical Effect of Double Incision and Double Plate Internal Fixation in the Treatment of Complex Tibial Plateau Fracture and Analysis of Its Effect on Load Bearing Time of Affected Limb

Abstract Purpose Surgical treatment of tibial plateau fracture (TPF) is common. Surgical site infections (SSI) are among the most serious complications of TPF. This multicentre study aimed to evaluate the effect of fracturoscopy on the incidence of surgical site infections in patients with TPF. Methods We performed a retrospective multicentre study. All patients with an AO/OTA 41 B and C TPF from January 2005 to December 2014 were included. Patients were divided into three groups: those who underwent arthroscopic reduction and internal fixation (ARIF), and those who underwent open reduction and internal fixation (ORIF) with fracturoscopy, and those treated with ORIF without fracturoscopy. The groups were compared to assess the effect of fracturoscopy. We characterised our cohort and the subgroups using descriptive statistics. Furthermore, we fitted a logistic regression model which was reduced and simplified by a selection procedure (both directions) using the Akaike information criterion (AIC). From the final model, odds ratios and inclusive 95% confidence intervals were calculated. Results Overall, 52 patients who underwent fracturoscopy, 48 patients who underwent ARIF, and 2000 patients treated with ORIF were identified. The rate of SSI was 0% (0/48) in the ARIF group and 1.9% (1/52) in the fracturoscopy group compared to 4.7% (93/2000) in the ORIF group (OR = 0.40, p = 0.37). Regression analyses indicated a potential positive effect of fracturoscopy (OR, 0.65; 95% CI, 0.07–5.68; p = 0.69). Conclusion Our study shows that fracturoscopy is associated with reduced rates of SSI. Further studies with larger cohorts are needed to investigate this. Level of evidence Level III.

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Total knee arthroplasty following internal fixation of a tibial plateau fracture

Injury Extra ◽

10.1016/j.injury.2004.12.065 ◽

2005 ◽

Vol 36 (8) ◽

pp. 352-354 ◽

Cited By ~ 1

Author(s):

M. Rowsell ◽

D. Gale

Keyword(s):

Total Knee Arthroplasty ◽

Internal Fixation ◽

Knee Arthroplasty ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Plateau Fracture ◽

Total Knee

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A Serious Vascular Complication of Internal Fixation of a Tibial Plateau Fracture

The Journal of Trauma: Injury, Infection, and Critical Care ◽

10.1097/00005373-199602000-00032 ◽

1996 ◽

Vol 40 (2) ◽

pp. 323-325 ◽

Cited By ~ 6

Author(s):

M.L. Rawes ◽

W.H. Harper ◽

O.O.A. Oni

Keyword(s):

Internal Fixation ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Vascular Complication ◽

Plateau Fracture

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Arthroscopy-Assisted Reduction Percutaneous Internal Fixation Versus Open Reduction Internal Fixation for Tibial Plateau Fracture: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211027838 ◽

2021 ◽

Vol 9 (12) ◽

pp. 232596712110278

Author(s):

Liangjun Jiang ◽

Erman Chen ◽

Lu Huang ◽

Cong Wang

Keyword(s):

Systematic Review ◽

Internal Fixation ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Open Reduction Internal Fixation ◽

Radiological Evaluation ◽

Plateau Fracture ◽

Mean Differences ◽

Percutaneous Internal Fixation

Background: Arthroscopy-assisted reduction percutaneous internal fixation (ARIF) has emerged recently as an alternative treatment method in treating lower-energy tibial plateau fractures. To date, the comparison of clinical efficacy between ARIF and open reduction internal fixation (ORIF) is limited, with divergent conclusions. Purpose: To review studies on the clinical efficacy of ARIF and ORIF in the treatment of tibial plateau fracture. Study Design: Systematic review; Level of evidence, 3. Methods: A search was conducted using the PubMed, Web of Science, Cochrane Library, and EMBASE databases between inception and August 20, 2020, for retrospective and prospective studies evaluating ARIF versus ORIF in the treatment of tibial plateau fracture. We identified 6 clinical studies that met the inclusion criteria, with 231 patients treated with ARIF and 386 patients treated with ORIF. The risk of bias and the quality of evidence of the included studies were assessed. The 2 treatment types were compared in terms of clinical results and complications by using odds ratios (ORs), mean differences (MDs), or standardized mean differences (SMDs), with 95% confidence intervals (CIs). Heterogeneity among studies was quantified using the I 2 statistic. Results: The quality of the studies was high. Compared with ORIF, treatment with ARIF led to better clinical function (SMD = 0.31; 95% CI, 0.14 to 0.48; I 2 = 15%; P = .0005), shorter hospital stay (MD = –2.37; 95% CI, –2.92 to –1.81; I 2 = 0%; P < .001), and more intra-articular lesions found intraoperatively (OR = 3.76; 95% CI, 1.49 to 9.49; I 2 = 66%; P = .005). There were no complications or significant differences between the techniques in the radiological evaluation of reduction. Conclusion: Compared with ORIF, the ARIF technique for tibial plateau fractures led to faster postoperative recovery and better clinical function and the ability to find and treat more intra-articular lesions during the operation. However, the radiological evaluation of reduction and complications were not significantly different between the 2 groups.

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