Department of Orthopedics, Mercy Health St. Vincent Medical Center, 2409 Cherry St, Toledo, OH, 43608, USA.
Superior Medical Experts, 1425 Minnehaha Ave E, P.O. Box 600545, St. Paul, MN, 55106, USA.
J Orthop Surg Res. 2022 Apr 7;17(1):210. doi: 10.1186/s13018-022-02973-1.
Schatzker type III fractures of the tibial plateau require elevation of the depressed portions to regain articular congruity. Balloon tibioplasty has been used as an alternative to conventional metal instruments for elevation of the lateral tibial plateau. This study compared functional outcomes following balloon tibioplasty or conventional osteosynthesis techniques in patients with type III fractures of the tibial plateau.
A systematic literature search was performed using PubMed, EMBASE, and Cochrane Library to identify studies published through March 29, 2021, pertaining to balloon tibioplasty or conventional osteosynthesis techniques for type III fractures. Non-human studies, opinion or editorial pieces, systematic reviews, case series (< 5 patients), and articles published in a non-English language were excluded. Primary outcomes were Rasmussen clinical score, range of motion, and Knee Society Score (KSS). A Joanna Briggs Institute (JBI) risk of bias assessment was performed for all studies.
A total of 95 studies were identified, with 10 studies (and 132 total patients) meeting inclusion criteria: 1 study focused on balloon tibioplasty, 8 studies reported outcomes following conventional osteosynthesis, and 1 study compared outcomes of the two techniques. Mean follow-up times varied widely, from 4 to 76.3 months. Where reported, balloon tibioplasty resulted in good to excellent functional outcomes as indicated by Rasmussen clinical scores (mean 28.3 in a case series; mean 28.9 in a randomized controlled trial) and range of motion (≥ 140° in both studies) 1-2 years following surgery. KSS was not reported consistently enough for comparison. Studies ranged from low to high risk of bias according to the JBI assessment.
Balloon tibioplasty can lead to excellent functional outcomes in patients with depression fractures of the lateral tibial plateau. More research is needed to directly compare outcomes following treatment with balloon tibioplasty or conventional osteosynthesis techniques.
胫骨平台 Schatzker 型 III 骨折需要抬高凹陷部位以恢复关节吻合。球囊扩骨术已被用作抬高外侧胫骨平台的传统金属器械的替代方法。本研究比较了胫骨平台 Schatzker 型 III 骨折患者采用球囊扩骨术或传统接骨术的功能结果。
通过 PubMed、EMBASE 和 Cochrane 图书馆进行系统文献检索，以确定截至 2021 年 3 月 29 日发表的关于胫骨平台 Schatzker 型 III 骨折的球囊扩骨术或传统接骨术的研究。排除非人类研究、观点或社论文章、系统评价、<5 例的病例系列研究以及非英语语言发表的文章。主要结果是 Rasmussen 临床评分、活动范围和膝关节学会评分（KSS）。对所有研究进行了 Joanna Briggs 研究所（JBI）偏倚风险评估。
共确定了 95 项研究，其中 10 项研究（共 132 例患者）符合纳入标准：1 项研究专注于球囊扩骨术，8 项研究报告了传统接骨术后的结果，1 项研究比较了两种技术的结果。平均随访时间差异很大，从 4 到 76.3 个月。在报告中，球囊扩骨术在手术后 1-2 年内通过 Rasmussen 临床评分（一项病例系列研究的平均 28.3；一项随机对照试验的平均 28.9）和活动范围（≥140°）获得了良好至优秀的功能结果。KSS 的报告不够一致，无法进行比较。根据 JBI 评估，研究的偏倚风险从低到高不等。
球囊扩骨术可使外侧胫骨平台凹陷骨折患者获得良好的功能结果。需要更多的研究来直接比较球囊扩骨术或传统接骨术治疗后的结果。
