![]() The surgical procedures of the two groups were as follows.įor patients in group 1 (MIS), the double reverse traction repositor, tunnel bone tamping method, and specially designed locking plates and slot-designed compression bolts were used for intraoperative reduction and fixation through MIPO. If significant intraarticular depression was observed, autogenous bone or allogeneic bone grafts were prepared. The supine position and a proximal tourniquet of the affected lower extremity were applied during surgery. Fig. 1 shows a chart of the trial design. In total, 187 patients (189 TPFs) were included and divided into two groups based on surgical methods (group 1, 84 patients (84 TPFs) obtained MIS treatment group 2, 103 patients (105 TPFs) obtained ORIF treatment). The exclusion criteria included: skeletally immature patients pathological or concomitant ipsilateral multiple fractures fractures managed by external fixation or other nonoperative means incomplete patient records and follow-up shorter than 3 years. The following inclusion criteria were applied: diagnosis of an acute, closed TPF administration of either the new MIS or ORIF and minimum of 3 years postoperative imaging data, including preoperative, immediate postoperative and final follow-up computed tomography (CT) scans and control X-ray. Between January 2015 and March 2018, a total of 513 skeletally mature patients with TPFs who underwent operated treatment were reviewed based on our prospectively level-I trauma center database. All methods were conformed to the ethical standards of the Declaration of Helsinki from 1964. Signed informed consent was obtained from all patients. The institutional review board of the ethics committee at our institution approved this study (Theoretical No. The authors describe this novel MIS technique, compare with the traditional ORIF, and share the results of this technique with medium-term follow up. Thus, the objective of this study was to compare the clinical and radiological outcomes of patients with TPFs after treatment utilizing either MIS or ORIF. If there was an obvious depression, the tunnel bone tamp technique was used to reversely reduce and elevate the depressed intraarticular fragments. The double reverse traction repositor, locking plates and specially designed slot-designed compression bolts were used to achieve reduction and stabilization of the displaced fracture fragments via minimally invasive plate osteosynthesis (MIPO). However, developing an optimal method that can treat all types of TPFs, maximize improved knee function and prevent the progression of posttraumatic arthritis is difficult.Ī novel and promising MIS has been developed for all types of TPFs. With technological advancements, many minimally invasive surgery (MIS) techniques for TPFs, such as the balloon technique, arthroscopy and bone tamp, have been performed among orthopedic surgeons, ,, ]. ![]() However, several pitfalls of ORIF, such as excessive bone damage and soft tissue injury, high infection risk and functional rehabilitation difficulties with delayed activity and scar formation. Open reduction internal fixation (ORIF) by plates and screws is the most commonly used method for TPFs and has achieved good clinical results. ![]() ![]() Various surgical approaches have been developed for TPFs. Anatomical reduction and effective fixation of articular fragments are essential for obtaining good knee function and preventing the progression of complications, such as early posttraumatic osteoarthritis, as far as possible. To restore articular congruity and limb alignment and enable early knee mobilization, surgical treatment is generally recommended for articular displacement or depression greater than 2 mm, condylar widening greater than 5 mm, malalignment greater than 5° or knee instability on full extension. Tibial plateau fractures (TPFs) account for 1–2% of all fractures in adults and are typically a consequence of combined axial force and varus or valgus to the knee.
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