INFLUENCE OF TWO KINDS OF INTERNAL FIXATION ON THE EFFICACY AND SAFETY OF PATIENTS WITH SCHATZKER TYPES I~III LATERAL TIBIAL PLATEAU FRACTURE

Qingchun Liu, Yefeng Zhao, Qiongmei Zhang^*

Department of Orthopedics, Putuo District Liqun Hospital, Shanghai (Second Military Medical University Teaching Hospital), 200333, PR China

Introduction: To explore the efficacy and safety of arthroscopy-assisted reduction and internal fixation and open reduction and internal fixation in patients with Schatzker types I~III lateral tibial plateau fracture. 

Materials and method: A total of 119 patients with Schatzker types I~III lateral tibial plateau fracture admitted to our hospital from January 2017 to January 2021 were included retrospectively. According to different surgical procedures selected by doctors, the patients were divided into the arthroscopy group (64 cases), who were treated with arthroscopy-assisted reduction and internal fixation and open group (55 cases), who were treated with open reduction and internal fixation. The general data, surgery time, incision length, intraoperative blood loss, hospital stay, soft tissue injury and excellent and good rates of the U.S. Hospital for Special Surgery (HSS) score 12 months after surgery of two groups were compared. 

Results: There was no significant difference between the two groups in terms of general data (P>0.05). The surgery time in the arthroscopy group was significantly longer than that in the open group (P<0.05). The incision length and intraoperative blood loss in the arthroscopy group were significantly less than those in the open group (P<0.05). There was no significant difference between two groups in hospital stay (P>0.05). The incidence of soft tissue injury in the arthroscopy group was significantly higher than that in the open group (P<0.05). The excellent and good rates of HSS score 12 months after surgery in the arthroscopy group were significantly higher than those in the open group (P<0.05). 

Conclusion: Compared with open reduction and internal fixation, arthroscopy-assisted reduction and internal fixation can effectively lower the degree of iatrogenic trauma and facilitate functional recovery in the treatment of Schatzker types I~III lateral tibial plateau fracture, but may increase surgery time.