Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstraße 20, 0410, Leipzig, Germany.
Clinic of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur J Trauma Emerg Surg. 2020 Dec;46(6):1249-1255. doi: 10.1007/s00068-020-01486-y. Epub 2020 Sep 15.
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.
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.
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).
Our study shows that fracturoscopy is associated with reduced rates of SSI. Further studies with larger cohorts are needed to investigate this.
Level III.
胫骨平台骨折（TPF）的手术治疗较为常见。手术部位感染（SSI）是 TPF 最严重的并发症之一。本多中心研究旨在评估骨折镜检查对 TPF 患者 SSI 发生率的影响。
我们进行了一项回顾性多中心研究。纳入 2005 年 1 月至 2014 年 12 月所有接受 AO/OTA 41 B 和 C 型 TPF 治疗的患者。患者分为三组：接受关节镜下复位内固定（ARIF）的患者，接受切开复位内固定并使用骨折镜检查（ORIF+fracturoscopy）的患者，以及接受单纯切开复位内固定（ORIF）的患者。比较各组以评估骨折镜检查的效果。我们使用描述性统计对队列和亚组进行了特征描述。此外，我们拟合了一个逻辑回归模型，通过使用赤池信息量准则（AIC）进行选择过程（双向）对其进行了简化和简化。从最终模型中计算出了比值比和包含 95%置信区间的范围。
总体而言，我们确定了 52 例接受骨折镜检查的患者、48 例接受 ARIF 的患者和 2000 例接受 ORIF 治疗的患者。ARIF 组 SSI 发生率为 0%（0/48），骨折镜组为 1.9%（1/52），而 ORIF 组为 4.7%（93/2000）（OR=0.40，p=0.37）。回归分析表明骨折镜检查有潜在的积极效果（OR，0.65；95%CI，0.07-5.68；p=0.69）。
我们的研究表明，骨折镜检查与 SSI 发生率降低有关。需要进一步开展更大规模队列的研究来对此进行调查。
III 级。
