Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study

Journal of Orthopaedic Surgery and Research

Sifan Yang¹  Qingcheng Song¹  Xiaodong Cheng¹  Zhanle Zheng¹  Hongzhi Hu²  Weijian Liu²  Jian Zhu³  Haitao Guan⁴  Xiangtian Deng⁴  Zhipeng Ye⁴  Boyu Zhang⁴  Yiran Zhang⁴  Yingze Zhang⁵ 

[1] Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, People’s Republic of China;NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, People’s Republic of China;Orthopaedic Institution of Hebei Province, 050051, Shijiazhuang, Hebei, People’s Republic of China;Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology, 430022, Wuhan, People’s Republic of China;School of Medicine, Nankai University, 300071, Tianjin, People’s Republic of China;School of Medicine, Nankai University, 300071, Tianjin, People’s Republic of China;Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, People’s Republic of China;NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, People’s Republic of China;School of Medicine, Nankai University, 300071, Tianjin, People’s Republic of China;Department of Orthopaedic Surgery of Hebei Province, Third Hospital of Hebei Medical University, 139 Ziqiang Road, 050051, Shijiazhuang, Hebei, People’s Republic of China;NHC Key Laboratory of Intelligent Orthopaedic Equipment, Third Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, People’s Republic of China;Orthopaedic Institution of Hebei Province, 050051, Shijiazhuang, Hebei, People’s Republic of China;

关键词: Bidirectional traction;    Lateral tibial plateau fractures;    Open reduction and internal fixation;    Closed reduction and internal fixation;    Arthroscopy;   

DOI  :  10.1186/s13018-021-02447-w

来源: Springer

【 摘 要 】

BackgroundLateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures.MethodsWe performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan.ResultsThe CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05).ConclusionThe present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.

【 授权许可】

CC BY