Chang Heng-Rui, Yu Yi-Yang, Ju Lin-Lin, Zheng Zhan-le, Chen Wei, Zhang Ying-Ze
Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, China.
Orthop Surg. 2018 May;10(2):77-83. doi: 10.1111/os.12372. Epub 2018 May 16.
Instead of extensive dissection of soft tissue around the fracture site, percutaneous techniques have unique advantages in managing displaced fragments, including preservation of soft tissues, less blood loss, lower risk of complications, and earlier functional rehabilitation. However, there are few systematic reviews on the effects of percutaneous reduction and internal fixation (PRIF) for tibial plateau fractures. A systematic search of Cochrane, EMBASE, and MEDLINE databases was performed for all publicly available data in March 2017 regarding the use of PRIF in treating monocondylar tibial plateau fractures. Basic information of included articles, surgical information, clinical outcomes, and concomitant soft tissue injuries were collected for analysis. Finally, a total of 20 articles including 561 patients were retrieved. Traffic accident was the most common cause of injury. Percutaneous techniques using bone tamp reduction were described in all studies. The majority (≥85%) of patients were classified as excellent or good according to clinical and radiological Rasmussen scores. The overall complication rate was 6.6%, with loss of reduction the most frequent complication with an incidence of 2.4%. This systematic review indicated that PRIF was an optimal alternative that physicians should consider for the treatment of monocondylar tibial plateau fractures.
与广泛解剖骨折部位周围的软组织不同，经皮技术在处理移位骨折块方面具有独特优势，包括保留软组织、减少失血、降低并发症风险以及更早进行功能康复。然而，关于经皮复位内固定（PRIF）治疗胫骨平台骨折效果的系统评价较少。2017年3月，我们对Cochrane、EMBASE和MEDLINE数据库进行了系统检索，以获取所有关于PRIF治疗单髁胫骨平台骨折的公开可用数据。收集纳入文章的基本信息、手术信息、临床结果以及伴随的软组织损伤情况进行分析。最终，共检索到20篇文章，涉及561例患者。交通事故是最常见的受伤原因。所有研究均描述了使用骨挤压复位的经皮技术。根据临床和放射学Rasmussen评分，大多数（≥85%）患者被评为优或良。总体并发症发生率为6.6%，复位丢失是最常见的并发症，发生率为2.4%。本系统评价表明，PRIF是治疗单髁胫骨平台骨折时医生应考虑的一种最佳选择。
